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Mohammad Adya Firmansha Dilmy

Tampilan Reseptor PPARγ Endometrium Eutopik dan Ektopik pada Wanita Usia Reproduksi Penderita Endometriosis = PPAR Expression in the Eutopic and Ectopic Endometrium of Reproductive Age Women with Endometriosis

"Tujuan: Menilai keberadaan reseptor PPARγ serta membandingkan tampilan reseptor PPARγ pada endometrium eutopik dan ektopik pada penderita endometriosis Metode: Penelitian ini merupakan penelitian potong lintang (cross sectional). Sepuluh subjek penderita endometriosis yang menjalani laparoskopi atau laparotomi, yang masuk dalam kriteria penerimaan (consecutive sampling) diambil dua percontoh, yakni endometrium eutopik dan endometrium ektopik yang berasal dari dinding kista endometriosis saat dilakukan pembedahan kemudian dilihat tampilan reseptor PPARγ dengan two-step RT-qPCR. Tampilan masing-masing percontoh diuji statistik dengan uji tes-t berpasangan dan tes korelasi Pearson.

Hasil: Didapatkan tampilan reseptor PPARγ pada endometrium eutopik dan endometrium ektopik penderita endometriosis dengan metode RT-qPCR. Tampilan resptor PPARγ endometrium eutopik dan ektopik didapatkan secara statistik tidak berbeda bermakna (1.16 lipatan relatif vs 1.25 lipatan relatif; p=0.26). Pada uji korelasi Pesrson didapatkakan korelasi positif lemah antara tampilan PPARγ endometrium eutopik dan ektopik (r=0.16).

Kesimpulan: Tampilan reseptor PPARγ pada endometrium eutopik dan ektopik penderita endometriosis didapatkan dengan metode two-step RT-qPCR. Dengan semikuantifikasi tampilan reseptor PPARγ tidak didapatkan perbedaan antara tampilan reseptor PPARγ pada endometrium eutopik dan ektopik pada penderita endometriosis. Terdapat korelasi positif lemah antara tampilan reseptor PPARγ pada endometrium eutopik dan ektopik pada penderita endometriosis.

Objective: To evaluate the expression of the PPARγ receptor and to compare its expression in the eutopic and ectopic endometrium in women with endometriosis Method: This is a cross sectional study. Ten female subjects with endometriosis that underwent laparoscopy or laparotomy that fulfilled the inclusion criteria were recruited by consecutive sampling. Two samples were taken, eutopic endometrium and ectopic endometrium from endometriosis cyst wall during surgery of each subject, PPARγ expression was examined by two-step RT-qPCR. Each sample was statistically examined using the paired t-test and Pearson’s corelation test.
Result: PPARγ was found to be expressed in the eutopic and ectopic endometrium of women with endometriosis using the RT-qPCR method. The expression of PPARγ was not statistically different in eutopic and ectopic endometrium (1.16 relative fold vs 1.25 relative fold:p=0.26). By Pearson’s corelation there was a weak positive corelation between PPARγ expression of the eutopic and ectopic endometrium (r=0.16).
Conclusion: PPARγ was detected by two-step RT-qPCR in eutopic and ectopic endometrium of women with endometriosis. Semiquantification of PPARγ expression showed that there was no significant difference betweenits expression in the eutopic and ectopic endometrium of women with endometriosis. There was a weak postive corelation of PPARγ expression between the eutopic and ectopic endometrium of women with endometriosis."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014

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Naivah Harharah

Perbandingan cadangan ovarium pada wanita infertil dengan dan tanpa endometriosis yang diukur dengan hormon anti muller (anti mullerian hormone) = Comparison of ovarian reserve in infertile women with and without endometriosis measured with anti mullerian hormone

"Membandingkan dan menentukan rerata kadar AMH serum pada wanita infertil dengan tanpa endometriosis serta mengetahui rerata kadar AMH serum pada masing-masing derajat endometriosis.

Metode: Penelitian ini merupakan penelitian potong lintang (cross sectional). Enam puluh delapan subjek yang menjalani laparoskopi, yang masuk dalam kriteria penerimaan dibagi menjadi dua kelompok sama besar, yakni kelompok endometriosis dan tanpa endometriosis secara konsekutif (consecutive sampling). Masing-masing subjek diambil percontoh dari darah sebelum dilakukan laparoskopi kemudian diukur kadar AMH serum. Rerata masing-masing kelompok diuji statistik dengan uji Mann-Whitney.

Hasil: Rerata kadar AMH serum pada kelompok endometriosis lebih rendah dibandingkan dengan tanpa endometriosis dan secara statistik berbeda bermakna (2,30+1,8 ng/ml vs 3,75+2,13 ng/ml; p=0,005). Dengan uji Kruskal-Wallis, didapatkan perbedaan bermakna secara statistik pada subjek kelompok endometriosis berdasarkan derajat endometriosis (p=0,005). Bila dilakukan pengelompokkan kelompok endometriosis minimal-ringan dan kelompok endometriosis sedang-berat dibandingkan dengan kelompok tanpa endometriosis, maka hasilnya menunjukkan tidak adanya hubungan yang bermakna antara kadar AMH serum pada kelompok endometriosis minimal-ringan dengan kelompok tanpa endometriosis (p=0,34), sedangkan pada kelompok endometriosis sedang-berat dengan kelompok tanpa endometriosis terdapat hubungan yang bermakna (p<0,005).

To compare and to determine the differences in levels of serum AMH in infertile women with and without endometriosis, and also to determine the mean levels of serum AMH in every grade of endometriosis.
Methods: This study is a cross-sectional study. Sixty-eight subjects who have undergone laparoscopy fulfilled the inclusion criteria are included and divided into two groups, i.e groups of endometriosis and without endometriosis consecutively (consecutive sampling). Blood samples are taken from each subject before laparoscopy which is then measured the levels of serum AMH. The mean levels of each group are tested with an Mann-Whitney test.
Results: The mean levels of serum AMH were lower in the endometriosis group than that group without endometriosis and it was statistically significance ( 2,30+1,8 ng/ml vs 3,75+2,13 ng/ml; p=0,005). With Kruskal-Wallis test, it was found that there was statistically significant difference among endometriosis group based on grading. There was no different at the mean levels of serum AMH between the minimal-mild endometriosis group and without endometriosis group (p=0,34), but the mean levels of serum AMH was lower in the moderate-severe endometriosis compare to the group without endometriosis and it was statistically significance (p<0,005).
Conclusions: The mean levels of serum AMH in infertile women with endometriosis were lower than that group without endometriosis and were statistically significantly different. There was no different between the mean levels of serum AMH in minimal-mild endometriosis group and that group without endometriosis, while in moderate-severe endometriosis group, it was lower than without endometriosis and it was statistically significance."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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Tirsa Verani K.

Profil metabolisme hormon estrogen pada penderita endometriosis = Profile of estrogen metabolism in endometriosis patients

"Latar belakang: Peran estrogen pada patofisiologi endometriosis sudah dikenal sejak lama. Namun, belum ada studi yang menganalisis rasio estradiol, estron dan estriol antara wanita dengan dan tanpa endometriosis.

Tujuan: Menganalisis kadar estron (E1), estradiol (E2) dan estriol (E3) dalam darah dan rasio E2:E1, E2:E3 dan E1:E3 antara wanita dengan dan tanpa endometriosis.

Metode: Penelitian dengan desain potong lintang analitik, dengan 27 wanita dengan endometriosis dan 27 wanita tanpa endometriosis yang memenuhi kriteria inklusi. Sampel didapatkan dari RS Cipto Mangunkusumo dan rumah sakit jejaring lainnya periode Oktober 2012 - April 2013. Kadar metabolit estrogen dalam darah diperiksa dengan uji enzyme-linked immunosorbent (ELISA). Perbandingan data antara dua kelompok dianalisis dengan uji Mann-Whitney.

Hasil: Kadar estron ditemukan lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol (54,66 pg/ml vs 73,52 pg/ml, p 0,229). Demikian pula, kadar estradiol dan estriol lebih rendah pada kelompok endometriosis (29 pg/ml vs 35 pg/ml, p 0,815 dan 1,11 pg/ml vs 1,67 pg/ml, p 0.095, berturut-turut). Rasio E2:E1 lebih tinggi pada kelompok endometriosis (0,51 pg/ml vs 0,38 pg/ml, p 0,164), demikian pula dengan rasio E2: E3 (26,53 pg/ml vs 21,11 pg/ml , p 0,223) dan rasio E1:E3 (58,55 pg/ml vs 50,28 pg/ml, p 0,684). Namun, semua perbedaan itu tidak bermakna secara statistik.

Kesimpulan: Kadar estron, estradiol, dan estriol pada wanita dengan kelompok endometriosis lebih rendah dibandingkan pada wanita tanpa endometriosis. Rasio E2: E1, E2: E3 dan E1: E3 lebih tinggi pada kelompok endometriosis. Namun, semua perbedaan itu tidak bermakna secara statistik.

Background: The role of estrogen in the pathophysiology of endometriosis has been well known. However, no study has observed the ratio of estradiol, estrone, and estriol between women with endometriosis and without endometriosis.
Objectives: To assess the estrone (E1), estradiol (E2) and estriol (E3) blood level and its ratio (E2:E1, E2:E3 and E1:E3) between women with and without endometriosis.
Methods: An analytical cross sectional study with 27 women with endometriosis and 27 women without endometriosis who met the inclusion criteria. The samples were recruited in Cipto Mangunkusumo hospital and other satellite hospitals from October 2012 to April 2013. The blood level of estrogen metabolites was examined by enzyme-linked immunosorbent assay (ELISA). The data comparison between two groups was analyzed by using Mann-Whitney test.
Result: The level of Estrone was found to be lower in endometriosis group compared to this in control group (54,66 pg/ml vs 73,52 pg/ml, p 0.229). Similarly, the level of estradiol and estriol were lower in endometriosis group (29 pg/ml vs 35 pg/ml, p 0.815 and 1,11 pg/ml vs 1,67 pg/ml, p 0.095, consecutively). The E2:E1 ratio was higher in endometriosis group (0,51 pg/ml vs 0,38 pg/ml, p 0.164), as well as E2:E3 ratio (26,53 pg/ml vs 21,11 pg/ml, p 0.223) and the E1:E3 ratio (58.55 vs 50.28, p 0.684). However, all those differences were not statistical significant.
Conclusion: The estrone, estradiol and estriol level in women with endometriosis group was lower compared to these in women without endometriosis group. The ratio E2:E1, E2:E3 and E1:E3 was higher in endometriosis group. However, all those differences were statistically insignificant."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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Hariyono Winarto

Peran stres oksidatif terhadap ekspresi gen supresor tumor arid1a pada sel endometriosis dan kanker ovarium = The role of oxidative stress in on the expression of the tumor suppressor gene arid1a in endometriosis cells and ovarian cancer

"Pendahuluan: Endometriosis merupakan suatu kelainan jinak ginekologi yang dapat mengalami transformasi menjadi kanker. Stres oksidatif diduga berperan dalam perkembangan penyakit endometriosis. Gen supresor tumor ARID1A banyak ditemukan termutasi dan inaktif pada kanker ovarium yang berhubungan dengan endometriosis. Tujuan penelitian adalah untuk menganalisis peran stres oksidatif terhadap ekspresi gen supresor tumor ARID1A dalam transformasi endometriosis menjadi ganas.

Metoda: Penelitian dimulai dengan 10 sampel jaringan kanker ovarium, 10 sampel endometriosis dan3 jaringan endometrium eutopik sebagai kontrol yang diisolasi mRNA dan proteinnya. Analisis ekspresi gen ARID1A pada tingkat mRNA dilakukan dengan pemeriksaan RT-qPCR dan pada tingkat protein dengan ELISA. Pada sel endometriosis dan kanker ovarium dilakukan analisis stres oksidatif dengan pemeriksaan aktivitas antioksidan MnSOD dan pemeriksaan kadar MDA sebagai salah bukti kerusakan salah satu komponen sel. Setelah itu dilakukan uji eksperimental pada kultur sel endometriosis dan endometrium eutopik sebagai kontrol. Kedua sel kultur diinduksi dengan H2O2 konsentrasi 0 nM, 100 nM, dan 1000 nM. Analisis dilakukan terhadap ketahanan hidup sel, kadar ROS dan ekspresi gen ARID1A pada tingkat mRNA dan protein.

Hasil: Efek induksi H2O2 dalam menekan ekspresi gen ARID1A sel endometriosis dan sel endometrium eutopik pada tingkat mRNA dan protein, bermakna, meskipun pada kanker ovarium tidak bermakna pada penelitian ini.

Kesimpulan: Stres oksidatif berperan dalam menekan ekspresi gen supresor tumor ARID1A ditingkat mRNA dan protein pada endometriosis.

Introduction: Endometriosis as a gynecologic benign lesion, can transform itself into cancer. Oxidative stress is considered as an important factor in endometriosis development. Studies found that ARID1A as tumor suppressor gene, was frequently mutated and inactivated in endometriosis associated ovarian cancer. The aim of the study is to analyze the role of oxidative stress on ARID1A expresion in endometriosis malignant transformation.
Methods: This study started with ten samples of ovarian cancer, ten samples of endometriosis, and 3 samples of eutopic endometrioid tissues as control. They were analyzed for the expression of ARID1A by RT-qPCR and ELISA, then analyzed for the activity of MnSOD as antioxidant enzyme and level of malondialdehyde as one of the oxidative stress damage effect evidence on cell's components. The second part of the study was experimental study on cultured eutopic endometrial and endometriosis cells. They were induced by H2O2 of 0, 100, and 1000 nM concentration. Analysis of the expression of ARID1A by RTqPCR and ELISA, and the DCFH-DA for the level of Reactive oxygen species were done.
Result: The impact of the H2O2 induction in repressing ARID1A gene expression on the endometriosis as well on the eutopic endometrium cells are significant, but not on the ovarian cancer in this study.
Conclusion: Oxidative stress has a role in repressing the expression of ARID1A gene at the mRNA and protein levels on the endometriosis."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014

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Valencia Astri Yuwono

Perbandingan profil metilasi gen hoxa 11 pada endometrium eutopik pasien endometriosis dengan infertilitas dan kelompok kontrol = Methylation profile of hoxa 11 gene in eutopic endometrium on endometriosis patient with infertility

"Latar Belakang: Endometriosis dan infertilitas memiliki keterkaitan yang sangat erat. Namun etiopatogenesis terjadinya infertilitas pada kasus endometriosis sangat beragam. Teori yang berkembang akhir-akhir ini adalah buruknya reseptivitas endometrium. Gen HOXA 11 adalah salah satu gen yang berperan dalam reseptivitas endometrium karena berkorelasi dengan penanda lain seperti Leukemia Inhibitory Factor LIF, B3integrin, dan EMX2. Teori epigenetik yang berkembang adalah terjadi hipermetilasi pada gen HOXA 11 sehingga terjadi penurunan ekspresi gen tersebut.

Metode: Penelitian potong lintang ini dilakukan di RS Cipto Mangunkusumo pada Juli 2015 - Juni 2016. Subjek penelitian adalah pasien endometriosis yang terbukti secara histopatologi dengan infertilitas dan kelompok kontrol merupakan pasien non-endometriosis yang fertil. Status metilasi gen HOXA 11 dari sampel endometrium eutopik pada kedua kelompok ini diperiksa dan dibandingkan.

Hasil: Enam pasien endometriosis dan enam pasien kontrol diambil sebagai subjek. Perbedaan tingkat metilasi gen HOXA 11 pada kedua kelompok ini berbeda secara signifikan dengan nilai p 0.03 dengan perbedaan rerata peningkatan kadar metilasi pada kelompok pasien endometriosis sebesar 33.

Kesimpulan: Gen HOXA 11 yang berperan dalam reseptivitas endometrium mengalami hipermetilasi pada pasien dengan endometriosis dan infertilitas.

Introduction: Endometriosis compromises infertility in some patients. They have close relationship and many etiologies have been proposed. HOXA11 has important role in window implantation because it is related to other endometrial receptivity markers such as Leukemia Inhibitory Factor LIF , B3integrin, and EMX2. Recently, many researchers found poor endometrial receptivity in endometriosis due to hyper methylation of HOXA11 gene. Therefore, this study aims to find out the HOXA11 gene profile on endometriosis patients with infertility in Indonesia.
Methods: This cross sectional study was conducted in Dr. Cipto Mangunkusumo Hospital from July 2015 June 2016. The subjects were endometriosis patients with infertility who have been confirmed histopathological. The control group was taken from non endometriosis and fertile patients. Eutopic endometrium samples were taken and examined for the methylation of HOXA11 gene.
Results: Both groups consist of six patients. The difference of methylation of HOXA 11 gene between those two groups is statistically significant p 0.03 . There was hyper methylation in endometriosis group.
Conclusion: There is a hyper methylation of HOXA 11 gene in eutopic endometrium of endometriosis patients with infertility. Thus, possibly can explain the poor endometrial receptivity in endometriosis patient and give a broad research area in epigenetic therapy of endometriosis."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017

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Yassin Yanuar Mohammad

Korelasi Rasio Ekspresi mRNA BAX dan BCL2 pada Sel Granulosa terhadap Kualitas Oosit pada Penderita Endometriosis yang Menjalani Fertilisasi In Vitro = Correlation of mRNA BAX and BCL-2 Ratio in Granulosa Cells with Oocyte Quality in Endometriosis Patients Undergoing In Vitro Fertilization

"Pengantar: Endometriosis merupakan salah satu penyebab infertilitas dan menjadi indikasi fertilisasi in vitro (FIV). Laju apoptosis dan stress oksidatif yang tinggi pada pasien endometriosis diyakini menimbulkan efek negatif terhadap peluang keberhasilan FIV. Namun, pengaruh endometriosis terhadap keberhasilan FIV menunjukkan bukti yang inkonsisten dan belum banyak studi yang menilai langsung efek endometriosis terhadap kualitas oosit sebagai parameter keberhasilan FIV.

Tujuan: Untuk menilai laju apoptosis pada sel granulosa pasien endometriosis dibanding pasien non-endometriosis melalui rasio ekspresi mRNA BAX/BCL-2 dan menilai korelasinya dengan kualitas oosit yang didapatkan saat petik ovum.

Hasil: Sampel didapatkan dari 15 subjek dengan endometriosis dan 15 subjek kontrol. Dosis rekombinan FSH total yang diterima pada kelompok endometriosis untuk stimulasi ovarium lebih tinggi dibandingkan kelompok kontrol (p=0.005). Terdapat perbedaan bermakna kadar ekspresi BAX (p=0.029) dan BCL-2 (p<0.001) pada kedua kelompok, tetapi perbedaan rasio keduanya tidak signifikan (p=0.787). Korelasi antara rasio BAX/BCL-2 dengan parameter kualitas oosit tidak menunjukkan hubungan bermakna di kedua kelompok.

Kesimpulan: Tidak terdapat perbedaan signifikan pada rasio kadar BAX/BCL-2 di kedua kelompok dan tidak ditemukan hubungan bermakna antara rasio tersebut dengan kualitas oosit.

Introduction: Endometriosis is one of common conditions causing infertility and an indication to undergo in vitro fertilization (IVF). High apoptosis rate and oxidative stress in patient with endometriosis is believed to cause negative effect on IVF success rate. However, there has been conflicting results on endometriosis effect to IVF success and there have been limited studies that directly assess endometriosis and its effect on oocyte quality.
Aim: To assess apoptosis rate on granulosa cells in patients with endometriosis compared to non-endometriosis patients through mRNA BAX/BCL-2 ratio and how it correlates with oocyte quality collected during ovum pick up.
Results: Samples were collected from 15 subjects with endometriosis and 15 control subjects. Total dose of recombinant FSH received by endometriosis group is significantly higher compared to control (p=0.005). There is difference in BAX level (p=0.029) and BCL-2 level (p<0.001) in both groups. However, the ratio does not differ significantly (p=0.787). No significant correlation is found in BAX/BCL-2 ratio and any of the oocyte quality parameters.
Conclusion: We found no significant difference in BAX/BCL-2 ratio between endometriosis and control group as well as significant correlation between the ratio and oocyte quality."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018

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UI - Tesis Membership Universitas Indonesia Library

Zeissa Rectifa Wismayanti

Ekspresi growth differentiation factor-9 (GDF-9) pada sel granulosa pasien fertilisasi in vitro: perbandingan kasus endometriosis dan non-endometriosis = Expressions of growth differentiation factor-9 (GDF-9) on granulosa cells of ivf patients: comparison between endometriosis and non-endometriosis cases

"Latar Belakang: Salah satu hipotesis yang menjelaskan hubungan endometriosis dengan infertilitas adalah endometriosis diyakini menyebabkan gangguan fisiologi ovarium, salah satunya dengan mempengaruhi folikulogenesis yang menyebabkan penurunan kualitas oosit. Oosit memainkan peran penting dalam mengatur dan mendukung pertumbuhan folikel, melalui produksi faktor pertumbuhan oosit. Beberapa faktor pertumbuhan telah diidentifikasi pada oosit manusia, termasuk growth differentiation factor-9 GDF-9 . Namun, sampai saat ini penelitian mengenai ekspresi GDF-9 pada sel granulosa pada wanita infertil dengan endometriosis masih belum banyak dilakukan.

Tujuan: Untuk mengetahui ekspresi mRNA GDF-9 pada sel granulosa pasien endometriosis yang menjalani FIV dan untuk mencari adanya korelasi antara ekspresi GDF-9 dengan kualitas oosit.

Metode: Penelitian potong lintang ini dilakukan di Klinik IVF Yasmin RSCM dan Klinik Sander B di Jakarta pada bulan Juli 2014 - Juli 2017. Sebanyak 50 sampel terdiri atas 25 wanita dengan endometriosis dan 25 kontrol. Sampel sel granulosa dikumpulkan pada saat petik oosit. Ekspresi mRNA GDF-9 dinilai menggunakan real time PCR.

Hasil: Terdapat penurunan jumlah ambilan oosit, jumlah oosit matur dan skor morfologi oosit pada kelompok pasien dengan endometriosis dan bermakna secara statistik. Ekspresi GDF-9 secara kuantitatif lebih rendah pada kelompok endometriosis dibandingkan dengan kontrol 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01 . Pada penelitian ini tidak didapatkan korelasi antara ekspresi GDF-9 dan kualitas oosit dari skor morfologi oosit dan laju fertilisasi.

Kesimpulan: Ekspresi GDF9 lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol. Namun, kami tidak menemukan korelasi antara ekspresi GDF-9 dengan kualitas oosit. Dibutuhkan studi dengan besar sampel yang lebih besar untuk mengkonfirmasi apakah perubahan ekspresi GDF-9 memiliki korelasi dengan kualitas oosit serta untuk membuktikan apakah GDF-9 dapat digunakan sebagai penanda molekuler baru untuk memprediksi kompetensi perkembangan oosit.

Background: One of the hypothesis that explains the association between endometriosis and infertility is that endometriosis is believed to cause ovarian physiology disturbances, one of them by affecting folliculogenesis that cause decreased oocyte quality. The oocyte plays an important role in regulating and promoting follicle growth, by the production of oocyte growth factors. Several growth factors have been identified in human oocytes, including growth differentiation factor-9 GDF-9. However the studies on GDF-9 expression in granulosa cells of infertile women with endometriosis are sparse.
Objective: To investigate the expression of GDF-9 mRNA in granulosa cells of endometriosis patients undergoing IVF and to find the correlation between GDF-9 expression and oocyte quality.
Method: This cross sectional study was done at Yasmin IVF Clinic and dr. Sander B Clinic Jakarta in July 2014 - July 2017. A total fifty samples of 25 womens with endometriosis and 25 controls were included. We collect the granulosa cells sample at the time of oocyte retrieval. GDF-9 mRNA expression were investigated by Real-Time PCR.
Result: The number of oocytes retrieved, mature oocytes and the oocyte morphology score were lower in the group of patients with endometriosis and this was statistically significant. GDF-9 mRNA expression levels was quantitatively lower in endometriosis groups compared to control 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01. However, we did not find any correlation between GDF-9 expression levels and oocyte quality from oocyte morphology score and fertilization rate.
Conclusion: GDF9 mRNA level was lower in endometriosis group compared to control group. However, we did not find correlation between individual GDF-9 level and oocyte quality. Large-sample studies were needed to confirm whether the expression of GDF-9 had a correlation with oocyte quality as well as to prove whether GDF-9 could be used as a new molecular marker to predict the oocyte developmental competence."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018

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UI - Tugas Akhir Universitas Indonesia Library

Familia Bella Rahadiati

Gambaran histopatologik dan ekspresi arid1a karsinoma ovarium pada model hewan coba dengan autoimplantasi endometrium dan induksi dmba = Histopathological features and arid1a expression of ovarian carcinoma in experimental animal models with endometrial autoimplantation and dmba induction

"Latar belakang: Karsinoma ovarium adalah salah satu keganasan paling mematikan di bidang ginekologik. Penyebab keganasan belum diketahui pasti dan umumnya tidak memiliki gejala klinik yang jelas. Karsinoma ovarium tipe I khususnya karsinoma endometrioid dan karsinoma sel jernih diketahui dapat berasal dari endometriosis. Karsinoma yang berasal dari endometriosis dikenal sebagai endometriosis-associated ovarian carcinoma (EAOC). Pengembangan model hewan coba karsinoma ovarium yang berhubungan dengan endometriosis diperlukan untuk penelitian dasar dan uji klinik menggantikan jaringan manusia. Pada penelitian ini dikembangkan model hewan coba karsinoma ovarium dengan teknik autoimplantasi dan induksi DMBA.

Bahan dan cara kerja: Penelitian ini mengunakan blok parafin dari tikusyang sebelumnya telah mendapatkan operasiplasebo (SHAM), autoimplantasi endometrium, kombinasi autoimplantasi endometrium dan induksi DMBAyangdikorbankan pada minggu ke-5,10, dan 20. Dilakukan penilaian histopatologik dan pulasan imunohistokimia ARID1A dengan penilaian persentase positivitas pada 200 sel.

Hasil: Penelitian ini menghasilkan lesi endometriosis atipik sebanyak 1 (20%) dan karsinoma sel jernih sebanyak 1 (20%)pada implantasi dan induksi DMBA 10 minggu dan karsinoma endometrioidsebanyak 100% pada kelompok induksi DMBA. Pulasan ARID1A tidak menunjukkan perbedaan bermakna (p=0,313) pada seluruh kelompok perlakuan.

Background: Ovarian carcinoma is one of the most deadly malignancies in the gynecologic field. The cause of malignancy is not known for sure and generally do not have clear clinical symptoms. Type I ovarian carcinoma especially endometrioid carcinoma and clear cell carcinoma is known to originate from endometriosis. Carcinoma originating from endometriosis is known as endometriosis-associated ovarian carcinoma (EAOC). The development of experimental animal models of ovarian carcinoma associated with endometriosis is needed for basic research and clinical trials replace human tissue. In this study an experimental model of ovarian carcinoma was developed with autoimplantation and DMBA induction techniques.
Materials and methods: This study used paraffin blocks from mice that had previously received placebo surgery (SHAM), endometrial autoimplantation, combination of endometrial autoimplantation and DMBA induction and were sacrificed at 5,10 and 20 weeks. Assessment of ARID1A expression by assessing the percentage of positivity in 200 cells.
Results: This study resulted in 1 (20%) atypical endometriosis lesions and 1 (20%) clear cell carcinoma in 10 weeks DMBA implantation and 100% endometrioid carcinoma in the DMBA induction group. ARID1A ekspression did not show a significant difference (p = 0.313) in all treatment groups."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019

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UI - Tesis Membership Universitas Indonesia Library

Retno Widyawati

Penurunan ekspresi ARID1A pada kista endometriosis non atipik, atipik, dan clear cell carcinoma ovarii = The decrease of the ARID1A expressions in non atypical, atypical endometriosis cyst, and ovarian clear cell carcinoma

"ABSTRAK

Latar belakang: Endometriosis merupakan kelainan ginekologik yang paling

sering ditemukan. Seperti halnya endometrium di uterus juga dapat terjadi

berbagai perubahan pada epitel yang melapisi kista endometriosis di ovarium,

antara lain metaplasia, hiperplasia, atipia bahkan perubahan ke arah keganasan.

Saat ini banyak penelitian yang menghubungkan antara endometriosis dan kanker

ovarium terutama jenis clear cell dan dikenal dengan istilah endometriosisassociated

ovarian carcinoma (EAOC) dan dilaporkan adanya mutasi yang

menginaktifkan gen supresor tumor (ARID1A), sehingga protein BAF250a tidak

diekpresikan pada Clear cell carcinoma (CCC) ovarii.

Bahan dan cara: Dilakukan pulasan imunohistokimia ARID1A pada sampel 20

kasus endometriosis non atipik, 20 kasus atipik dan 20 kasus CCC ovarii tahun

2012 hingga Maret 2015. Dari kelompok kasus CCC didapatkan 9 kasus EAOC.

Selanjutnya dilihat adakah perbedaan persentase ekspresi ARID1A pada

endometriosis non atipik, atipik, CCC ovarii serta endometriosis disertai CCC

(EAOC).

Hasil: Pada kelompok kasus endometriosis non atipik, atipik dan CCC ada

perbedaan bermakna persentase ekspresi ARID1A (uji Kruskal-Wallis p=0,0035).

Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan didapatkan

perbedaan bermakna persentase ekspresi ARID1A antara endometriosis non atipik

dan atipik dengan CCC ovarii (p=0,001 dan p=0,0015). Pada kelompok kasus

endometriosis non atipik, atipik dan endometriosis pada EAOC, didapatkan ada

perbedaan bermakna persentase ekspresi ARID1A (Uji Kruskal-Walis p=0,011).

Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan ada perbedaan

bermakna persentase ekspresi ARID1A antara endometriosis non atipik dan atipik

dengan EAOC (p=0,005 dan p=0,008).

Kesimpulan: Ekspresi ARID1A pada endometriosis non atipik dan atipik lebih

tinggi bermakna dibanding CCC ovarii dan EAOC. Sehingga ekspresi ARID1A

kemungkinan dapat digunakan sebagai petanda adanya transformasi ganas pada

endometriosis.

ABSTRACT

Background: Endometriosis is one of the most common gynecological

abnormalities found. Endometriosis cyst in the ovary also exhibited changes in

epithelial cyst just like endometrium in the uterus. Changes in the epithelial cells

also include metaplasia, hyperplasia, atyphia even changes toward malignan

characteristics. Nowadays, there are some research that linked endometriosis and

clear cell ovarian cancer which is known with endometriosis-associated ovarian

carcinoma (EAOC) it is reported that there?s a mutation that activated tumor

suppressor gene (ARID1A), so protein BAF250a is not expressed in Clear Cell

Carcinoma (CCC) in the ovarium.

Materials and Methods: Immunohistochemistry staining of ARID1A were done

in 20 samples of non-atypical endometriosis, 20 samples of atypical

endometriosis, 20 samples of CCC in the ovarium from the year 2012 until march

2015. From the group that experienced CCC we get 9 cases of EAOC. After that,

we see if there?s any difference in the percentage of ARID1A expression in nonatypical

endometrosis, atypical endometriosis, CCC in the ovarium and

endometriosis with CCC( EAOC).

Results: In non-atypical endometriosis, atypical and CCC cases groups there are

significant differences on the percentage of ARID1A expression (Kruskal-Walis

test p=0,0035). Post Hoc analysis were done using Mann-Whitney test and there

are significant differences on ARID1A expression between non-atypical and

atypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypical

endometriosis, atypical and EAOC groups there are significant differences on the

percentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hoc

analysis were done using Mann-Whitney test and there are significant differences

on ARID1A expression between non-atypical and atypical endometriosis with

EAOC (p=0,005 and p=0,008).

Conclusion: Expression of ARID1A in non atypical and atypical endometriosis

are significantly higher compared to ovarian CCC and EAOC. So, we can say that

ARID1A may be used as a marker for malignancy transformation in

endometriosis.

;Background: Endometriosis is one of the most common gynecological