xii HUBUNGAN EKSPRESI RESEPTOR PROGESTERON DENGAN DIFERENSIASI SEL DAN STADIUM KARSINOMA ENDOMETRIUM
Ratih Puty Hariandy
Departemen Obstetri dan Ginekologi, Fakultas Kedokteran , M. Fauzie Sahil, Sarah Dina
Universitas Sumatera Utara, Rumah Sakit Umum Pusat H. Adam Malik
Abstrak
Latar belakang. Karsinoma endometrium adalah tumor ganas epitel primer di endometrium dan menempati urutan kedua keganasan
ginekologi setelah karsinoma serviks. Angka kejadian karsinoma
endometrium meningkat seiring dengan meningkatnya usia harapan hidup
dan epidemik obesitas. Pembedahan merupakan terapi definitif, namun
beberapa pasien dengan faktor resiko surgikopatalogis perlu diberikan
terapi adjuvan. Penilaian reseptor hormon, dalam hal ini reseptor
progesteron, dapat dijadikan alternatif dalam menilai faktor resiko pasien
apakah membutuhkan terapi adjuvan setelah pembedahan dimana hal ini
akan mempengaruhi prognosis pasien.
Metode. Penelitian ini adalah penelitian cross sectional. Enam puluh lima sampel terdiri atas blok parafin jaringan endometrium dari
pasien karsinoma endometrium tipe I yang menjalani pembedahan di
Rumah Sakit Umum Pusat Haji Adam Malik Medan. Dilakukan
pemeriksaan imunohistokimia untuk menilai ekspresi reseptor
progesteron, dan dilakukan analisis statistik untuk menilai hubungannya
dengan diferensiasi sel dan stadium karsinoma endometrium dan
xiii kemudian dilakukan analisis statistik. Analisa statistik uji kai kuadrat
dengan tingkat kepercayaan sebesar 95%, p<0.05 dianggap bermakna.
Hasil. Dari 65 pasien karsinoma endometrium, dijumpai mayoritas berusia > 50 tahun (67.7%), Indeks Massa Tubuh (IMT) overweight
(44.6%), diferensiasi sel baik (44.6%) dan mayoritas stadium III (41.5%).
Ekspresi reseptor progesteron positif ditemukan pada 30 pasien (46.2%)
dan negatif pada 35 pasien (53.8%). Pada penelitian ini dijumpai adanya
hubungan yang signifikan antara reseptor progesteron dengan diferensiasi
sel dan stadium karsinoma endometrium (p<0.005). Semakin lemah
ekspresi reseptor progesteron maka semakin buruk diferensiasi sel (r =
-0.659) dan semakin tinggi stadium karsinoma endometrium (r = - 0.428).
Kesimpulan: Ada hubungan yang signifikan antara reseptor progesteron dengan diferensiasi sel dan stadium karsinoma
endometrium(p<0.05). Semakin lemah ekspresi reseptor progesteron
maka semakin buruk diferensiasi (r = -0.659) sel dan semakin tinggi
stadium karsinoma endometrium (r = - 0.428).
Kata Kunci. Karsinoma endometrium, reseptor progesteron, diferensiasi sel, stadium.
xiv THE RELATIONSHIP BETWEEN PROGERSTERONE RESEPTOR EXPRESSION WITH CELL DIFFERENTIATION AND THE STAGE OF
ENDOMETRIAL CARCINOMA Ratih Puty Hariandy
Departement of Obstetric dan Gynecology, Medical School, , M. Fauzie Sahil, Sarah Dina
University of North Sumatera, H. Adam Malik General Hospital, Medan
Abstract
Introduction. Endometrial carcinoma is a primary malignant tumor in the endometrial epithelium and the second gynecologic malignancy
after cervical carcinoma. The incidence of endometrial carcinoma
increased as the increasing of life expectancy and obesity epidemic.
Surgery is the definitive therapy but some patients with
pathologicosurgical risk is necessary adjuvant therapy. Assestment of
hormone receptor, in this case is progesterone receptor, could be
applicable in evaluating risk factors patients whereby it will affect the
prognosis.
Method. This is cross-sectional study. Sixty-five sample consisting of block paraffin tissue of the endometrium from endometrial carcinoma
cancer type I who underwent surgery in Adam Malik General Hospital
Medan. Immunohistochemistry assay to assess progesterone receptor
expression and statistical analysis performed to assess the relationship
between progesterone receptor expression with cell differentiation and the
stage of endometrial carcinoma. Chi-square analysis with confidence of
interval 95%, p<0.05 is significant.
xv Result. Of Sixty-five endometrial carcinoma patients, found the majority of age is > 50 years (67.7%), with BMI overweight (44.6%),
well-differentiated cell (44.6%) and stage III (41.5%) . Positive progesterone
receptor expression found in 30 patients (46.2%) and negative in 35
patients (53.8%). In this study found there is significance relationship
between cell differentiation and the stage of endometrial carcinoma
(p<0.05). The decreasing of progesterone receptor expression the poorer
cell differentiaton (r = -0.659) and increasing the stage of endometrial
carcinoma (r = -0.428).
Conclusion: There is significance relationship between progesterone receptor expression with cell differentiation and the stage of
endometrial carcinoma (p<0.05). The decreasing of progesterone receptor
expression the poorer cell differentiaton (r = -0.659) and increasing the
stage of endometrial carcinoma (r = -0.428).
Keyword: Endometrial Carcinoma, Progesterone Receptor, Cell Differentiation, Stage.
