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"ABSTRAKLatar 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 endometriosis-associated 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.

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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 non-atypical 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."

"ABSTRAK Latar belakang: Endometriosis merupakan kelainan ginekologik yang palingsering ditemukan. Seperti halnya endometrium di uterus juga dapat terjadiberbagai 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 kankerovarium terutama jenis clear cell dan dikenal dengan istilah endometriosisassociatedovarian carcinoma (EAOC) dan dilaporkan adanya mutasi yangmenginaktifkan gen supresor tumor (ARID1A), sehingga protein BAF250a tidakdiekpresikan pada Clear cell carcinoma (CCC) ovarii.Bahan dan cara: Dilakukan pulasan imunohistokimia ARID1A pada sampel 20kasus endometriosis non atipik, 20 kasus atipik dan 20 kasus CCC ovarii tahun2012 hingga Maret 2015. Dari kelompok kasus CCC didapatkan 9 kasus EAOC.Selanjutnya dilihat adakah perbedaan persentase ekspresi ARID1A padaendometriosis non atipik, atipik, CCC ovarii serta endometriosis disertai CCC(EAOC).Hasil: Pada kelompok kasus endometriosis non atipik, atipik dan CCC adaperbedaan bermakna persentase ekspresi ARID1A (uji Kruskal-Wallis p=0,0035).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan didapatkanperbedaan bermakna persentase ekspresi ARID1A antara endometriosis non atipikdan atipik dengan CCC ovarii (p=0,001 dan p=0,0015). Pada kelompok kasusendometriosis non atipik, atipik dan endometriosis pada EAOC, didapatkan adaperbedaan bermakna persentase ekspresi ARID1A (Uji Kruskal-Walis p=0,011).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan ada perbedaanbermakna persentase ekspresi ARID1A antara endometriosis non atipik dan atipikdengan EAOC (p=0,005 dan p=0,008). Kesimpulan: Ekspresi ARID1A pada endometriosis non atipik dan atipik lebihtinggi bermakna dibanding CCC ovarii dan EAOC. Sehingga ekspresi ARID1Akemungkinan dapat digunakan sebagai petanda adanya transformasi ganas padaendometriosis.ABSTRACT Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. 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 nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. 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 nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. 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 nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. 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 nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis."

"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.

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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."

"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.

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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."

"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.

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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."

"ABSTRAKLatar Belakang: Endometriosis merupakan kondisi yang sering ditemukan pada wanita usia reproduksi. Keterlambatan dignosis masih menjadi kendala. Saat ini, metode diagnosis non invasif termasuk transvaginal sonography telah direkomendasikan. Penelitian ini bertujuan mengevaluasi akurasi transvaginal sonogrpahy untuk mendiagnosis kista endometriosis di RS Cipto MangunkusumoMetode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di RS Cipto Mangunkusumo pada Januari 2014 ? Juni 2015. Subjek penelitian merupakan pasien rawat jalan dengan kecurigaan kista endometriosis berdasarkan anamnesis dan pemeriksaan fisik. Pasien kemudian diperiksa transvaginal sonography oleh pemeriksa berpengalaman sesuai dengan protokol penelitian. Selanjutnya, pemeriksaan histologi dengan sediaan masa yang diambil dari prosedur operasi dijadikan baku emasHasil: Terkumpul 98 pasien yang dianalisis. Kista endometriosis terkonfirmasi pada 85 pasien (86,7%) berdasarkan pemeriksaan histologi. Akurasi, sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif transvaginal sonography yakni 84,9 (71,0-98,8)%, 92,9%, 76,9%, 96,3%, and 62,5%. Transvaginal sonography memiliki area under the curve yang lebih tinggi secara signifikan dibandingkan dengan hanya pemeriksaan fisik (84,9% vs 78,8%).Kesimpulan: Transvaginal sonogprahy bermanfaat untuk mendiagnosis kista endometriosis dan dapat direkomendasikan dalam praktik sehari-hari

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ABSTRACTBackground: Endometriosis is common among reproductive age women. Late diagnosis is still the main concern. To date, non-invasive diagnostic test including transvaginal sonography is recommended. This study aimed to evaluate the accuracy of transvaginal sonography to diagnose endometriosis cyst among patients in Cipto Mangunkusumo Hospital.Method: This was a diagnostic study performed in Cipto Mangunkusumo Hospital from January 2014 to June 2015. Outpatients with suspicion to have endometrial cyst based on patients? history and clinical examination were recruited. Patients were then scanned by experienced sonologist using transvaginal sonography following our research protocol. The gold standard was histologic finding of removed surgical massResults: A total of 98 patients were analyzed. Endometrial cyst was confirmed by histology among85 patients (86.7%). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal sonography were 84.9 (71.0-98.8)%, 92.9%, 76.9%, 96.3%, and 62.5%, respectively. Transvaginal sonogpraphy significantly had higher area under the curve compared to clinical examination alone (84.9% vs 78.8%).Conclusion: Transvaginal sonography appears to be usefull to diagnose endometriosis cyst among outpatients and recommended in daily clincial practice"

"Latar belakang: Untuk menilai peningkatan imunitas selular terhadap biakan sel endometriosis dari sel LAK hasil perangsangan Sel Mononuklir Darah Tepi (SMDT) penderita endometriosis dengan IL-2. Metode: Studi ini merupakan penelitian kuasi-eksperimental pra dan pasca-perlakuan dengan menggunakan pembanding (kontrol). Dilakukan pemeriksaan fenotip CD3+ CD4+, CD3+ CD8+ dan CD56+ sel efektor dari SMDT endometriosis dan kontrol. Dilakukan pula uji sitotoksisititas SMDT penderita endometriosis dan kontrol terhadap lini-sel Daudi, K562, dan biakan sel endometriosis dengan menggunakan 51 Chromium pada teknik teraradioimun (radioimmunoassay, RIA). Hasil: Pada pemeriksaan fenotip SMDT dari 10 pasien endometriosis dan 6 pasien kontrol pada sebelum dan sesudah perangsangan dengan IL-2 ditemukan bahwa sebelum perangsangan dengan IL-2 ditemukan CD3+CD4+, CD56+ pada kelompok endometriosis lebih rendah daripada kelompok kontrol (p>0,05); fenotip CD3+ CD8+ pada kelompok endometriosis lebih tinggi daripada kelompok kontrol. Setelah perangsangan dengan IL-2 ditemukan CD3+CD8+, CD56+ dari SMDT kelompok endometriosis lebih tinggi daripada sebelum perangsangan dengan IL-2 dan ditemukan perbedaan yang bermakna (p < 0,05). Pada uji sitotoksisitas ditemukan peningkatan bermakna (p < 0,05) sitotoksisitas sel efektor baik pada SMDT endometriosis maupun SMDT kontrol terhadap sasaran (target) lini-sel Daudi dan K562 setelah perangsangan IL-2. Sitotoksisitas sel efektor baik pada SMDT endometriosis maupun SMDT kontrol terhadap sasaran biakan sel endometriosis setelah perangsangan IL-2 tampak meningkat. Kesimpulan: Sel LAK hasil perangsangan SDMT penderita endometriosis dengan IL-2 meningkatkan imunitas selular terhadap biakan sel endometriosis. (Med J Indones 2011; 20:87-93 ).

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Background: To assess the increased cellular immunity of Peripheral Blood Mononuclear Cells (PBMC) derived LAK cells from endometriosis patients towards endometriosis cell cultures after stimulation with IL-2.

Methods: This study is a quasi-experimental study of pre and post treatment using controls. Phenotype evaluation of CD3+CD4+, CD3+CD8+ and CD56+ effector cells of PBMC from endometriosis patients and controls was performed. Cytotoxicity test of PBMC from endometriosis patients and control towards Daudi, K562 cell line and endometriosis cell cultures using 51Chromium release assay was also carried out.

Results: Phenotype evaluation of PBMC from endometriosis patients (n=10) and controls (n=6) were done prior to and after IL-2 stimulation. Before IL-2 stimulation, CD3+CD4+, CD56+ from endometriosis group (n=10) tend to be lower than control (n=6) whereas CD3+CD8 + were higher in endometriosis group than controls. After IL-2 stimulation, CD3+ CD8+, CD56+ of PBMC from endometriosis group were signifi cantly increased (p <0.05).Cytotoxicity test revealed a signifi cant increase (p <0.05) in both PBMCâ??s effector cells from endometriosis and control group towards target cells, Daudi, and K562 cell lines after IL-2 stimulation. PBMCâ??s effector cells cytotoxicity from both endometriosis and control towards target endometriosis cell cultures were also elevated after IL-2 stimulation.

Conclusion: LAK cells derived IL-2 stimulated PBMC from endometriosis patients increased cellular immunity towards endometriosis cell cultures. (Med J Indones 2011; 20:87-93 )."

"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).

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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."

"Latar belakang: Meski krusial untuk keberhasilan fertilisasi in vitro (FIV), stimulasi ovarium terkendali (SOT) diketahui dapat menurunkan reseptivitas endometrium dan mempengaruhi keberhasilan prosedur tersebut secara keseluruhan. Hal ini terkait dengan administrasi recombinant follicle stimulating hormone (r-FSH) yang meregulasi ekspresi regulator reseptivitas endometrium, termasuk leptin, melalui perantara estradiol.Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh pemberian berbagai dosis r-FSH pada SOT terhadap perubahan ekspresi leptin pada jaringan endometrium Macaca nemestrina (beruk).Metode: Penelitian ini menggunakan blok parafin berisi jaringan uterus Macaca nemestrina fase midluteal dari penelitian sebelumnya. Subjek adalah 15 beruk betina usia reproduktif (8-10 tahun) dengan riwayat melahirkan yang dibagi ke dalam empat kelompok: kelompok dengan administrasi r-FSH dosis 30 IU, 50 IU, 70 IU (kelompok intervensi), dan tanpa pemberian r-FSH (kelompok kontrol). Stimulasi ini diberikan selama 10 atau 12 hari pertama siklus haid. Pewarnaan dilakukan secara immunohistokimia. Ekspresi leptin diukur menggunakan plugin IHC Profiler pada software ImageJ serta dihitung secara semikuantitatif sebagai Histological Score (H-score). Analisis statistik untuk data normal dan homogen dilakukan dengan ANOVA satu arah, sedangkan untuk data tidak normal atau tidak homogen dilakukan dengan uji Kruskal-Wallis.Hasil dan Pembahasan: Pengaruh SOT pada jaringan endometrium ditemukan pada kompartemen epitel kelenjar, stroma, dan epitel luminal. Perbedaan ekspresi leptin antara keempat kelompok pada ketiga kompartemen tersebut bersifat tidak bermakna secara signifikan (Fkelenjar(3,10) = 0.464, p = 0.714; pstroma = 0.436; pluminal = 0.155). Hasil ini kemungkinan disebabkan oleh hubungan r-FSH dan leptin yang tidak bersifat langsung, tetapi diperantarai oleh estradiol. Limitasi penelitian ini adalah jumlah sampel yang kecil, serta keterbatasan dalam mengukur durasi fase siklus haid dan cadangan ovarium pada subjek penelitian."

"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. 

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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."