Analisis Hubungan Ekspresi Mrna COX-2, EP2 dan EP4 Dengan Kejadian Perdarahan Uterus Abnormal Pada Adenomiosis

dr Irmiya Rachmiyani, Dr. dr. Shofwal Widad, SpOG, Subsp.F.E.R.; dr. Didik Setyo Heriyanto, Ph.D., Sp.P.A., Subsp.D.H.B. (K), Subsp. Kv.R.M. (K)

2026 | Tesis-Subspesialis | SUBSPESIALIS OBSTETRI DAN GINEKOLOGI

Latar belakang: Adenomiosis merupakan penyakit ginekologis pada perempuan premenopause dengan manifestasi dismenorea, infertilitas dan keluhan perdarahan uterus abnormal (PUA). Mekanisme yang mendasari PUA masih belum jelas, meskipun ekspresi gen COX-2, EP2 dan EP4 diduga menyebabkan gangguan regenerasi dan stabilitas jaringan uterus. 

Tujuan: Penelitian ini bertujuan untuk membandingkan ekspresi mRNA COX-2, EP2 dan EP4 pada pasien yang mengalami adenomiosis dengan PUA dan tanpa PUA.

Metode: Studi potong lintang pada 20 sampel yang mengalami PUA dan 20 tanpa PUA. Sampel penelitian adalah jaringan terfiksasi formalin dalam blok paraffin uterus dengan gambaran histologi terkonfirmasi adenomiosis. Kriteria inklusi jaringan perempuan premenopause dengan gambaran adenomyosis. Kriteria eksklusi jaringan sudah rusak atau data tidak lengkap pada rekam medis elektronik, dan pemberian terapi hormonal pre operatif. Penilaian ekspresi mRNA COX-2, EP2 dan EP4 diukur dengan pemeriksaan RT-PCR. Data dianalisis menggunakan SPSS versi 25 dengan uji Chi-Square, Independent Sample t-Test dan Mann-Whitney.

Hasil: Penilaian karakteristik pasien meliputi usia, Indeks Massa Tubuh (IMT), jumlah paritas serta ukuran volume uterus. Terdapat kemaknaan (p<0 p=0,002) xss=removed>

Kesimpulan: Ekspresi mRNA COX-2, EP2 dan EP4 pada pasien adenomiosis dengan PUA lebih rendah dibandingkan dengan pasien adenomiosis tanpa PUA

Introduction: Adenomyosis is a gynecological disease in premenopausal women, characterized by dysmenorrhea, infertility, and abnormal uterine bleeding (AUB). The underlying mechanism of AUB remains unclear, although COX-2, EP2, and EP4 gene expression is thought to disrupt uterine tissue regeneration and stability.

Objective: This study aimed to compare COX-2, EP2, and EP4 mRNA expression in patients with adenomyosis with and without AUB.

Methods: A cross-sectional study of 20 patients with AUB and 20 without AUB was conducted. The study samples were formalin-fixed paraffin blocks of uterine tissue with histologically confirmed adenomyosis. Inclusion criteria was tissue from premenopausal adenomyosis women. Exclusion criteria included damaged tissue or incomplete data in the electronic medical record, and preoperative hormonal therapy. COX-2, EP2, and EP4 mRNA expression was measured by RT-PCR. Data were analyzed using SPSS version 25 with the Chi-Square, Independent Sample t-Test, and Mann-Whitney tests.

Results: Patient characteristics were assessed age, Body Mass Index (BMI), parity, and uterine volume. There was significant (p<0 p=0.002) p=0.001.>

Conclusion: COX-2, EP2, and EP4 mRNA expression in adenomyosis patients with AUB was lower than in adenomyosis patients without AUB.

Kata Kunci : Adenomiosis, perdarahan uterus abnormal, COX-2, EP2, EP4, Adenomyosis, abnormal uterine bleeding, COX-2, EP2, EP4