Ekspresi Gen Hoxa 10 di Jaringan Endometrium pada Penderita Mioma Uteri

Abstract

Background: Uterine fibroids are the most common benign tumors in reproductive-aged women, occurring in 20-50% of the reproductive-aged population. Homeotic genes, including homeobox genes (HOX/Hox), play a crucial role in organogenesis and the function of the adult female uterus. HOXA/Hoxa genes, such as HOXA10, HOXA11, and HOXA13, have significant contributions to the development of the female reproductive tract and embryo implantation. Decreased expression levels of the HOXA10 gene are associated with changes in endometrial implantation. Fibroids, benign tumors in the uterus, affect the expression of the HOXA10 gene and growth factors involved in implantation. Molecules produced by fibroids can disrupt the receptive function of the endometrium. Studies have found decreased expression of the HOXA10 gene in submucosal and intramural fibroids. Disruption of gene expression can lead to implantation failure and changes in endometrial function. Objective: This study aims to evaluate the gene expression of HOXA10 in endometrial tissue in patients with uterine fibroids. Methods: This study was an observational analytical study with a case-control design to assess the difference in HOXA10 gene expression in endometrial tissue between patients with uterine fibroids and patients without uterine fibroids at H. Adam Malik Central General Hospital and Medan Hospital Network, involving 22 women in each group. The study was conducted at the Department of Obstetrics and Gynecology, USU Hospital. Results: The study found that in the normal uterine fibroid group, the majority (60%) showed HOXA10 expression at level +3, while only 5% had expression at level +1. In the abnormal uterine fibroid group, 55% of cases showed HOXA10 expression at level +1, and only 5% had expression at level +3. In submucosal and intramural uterine fibroids, the majority (76.48%) exhibited HOXA10 gene expression at level +1, followed by 6 cases (100%) with expression at level 0. Chi-square statistical analysis revealed a significant difference in HOXA10 expression between the normal uterine fibroid group and the abnormal uterine fibroid group (p<0.05). There was a significant association between uterine fibroid classification and HOXA10 expression level (p<0.05). Conclusion: Based on this study, it was found that there were differences in HOXA10 gene expression between the normal uterine fibroid group and the abnormal uterine fibroid group. Statistical analysis revealed significant differences in HOXA10 gene expression between the normal and abnormal uterine fibroid groups, as well as a significant association between uterine fibroid classification and the gene expression level.