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Progesterone receptors in normal leiomyoma and myometrium

Marsellus B. Panggono, Maria FT Loho, Jefferson Rompas

Obstetric and Gynecology Department


Faculty of Medicine, University of Sam Ratulangi
Central Public Hospital Prof. Dr. RD Kandou Manado

Abstract

Background The uterine leiomyomas are benign tumors in reproductive aged women
that most often found from the smooth muscle of the uterine myometrium. The growth
of uterin myomas were associated with estrogen and its receptor. It is influenced by the
interaction of progesterone with several growth factors. Progesterone are regulated the
EGF (mitogenic) and changing the growth factor (TGF-) β3. The growth of myomas is
a balance between cell proliferation and apoptosis, the effect of progesterone on
apoptosis is to increase expression of anti-apoptotic protein Bcl-2 (Cell lymphoma B).
objective: To determine the density levels of progesterone receptors in
leiomyoma and the normal myometrium.
Method: This study was a cross sectional study with desktriptif analytic methods,
perform with immunohistochemistry to detect progesterone receptors in normal
uterine leiomyomas and myometrium tissues that taken from the same patients
after undergoing a hysterectomy in Prof. Dr. RD Kandou Manado hospital and
satellite hospital in Manado since November 2017 until January 2018.
Results: The most characteristics of respondents based on age of the patients were
aged over 46 was 10 people (62.5%). Based on menstrual status, the majority of the
sample who had entered menopause was 9 people (56.25%). Based on the location of
leiomyomas, most respondents who had intramural myomas was 14 people (87.5%),
while based on the popularity of menstrual complaints, most respondents who had
HMB was 12 people (75%). Based on the statistical test by Mann – Whitney method,
the result was p = 0.000 (p <0.05). This shows that there are significant differences
between normal tissue progesterone receptors and progesterone receptors at the same
uterine leiomyomas.
Conclusion: The growth of uterin myomas were associated with estrogen,
progesterone and its receptor. The density of progesterone in leiomyomas was
higher than in normal myometrium and there was a statistically significant
differences. The growth of leiomyoma is influenced by the interaction of
progesterone with several growth factors (growth factor).

Keywords: leiomyoma, receptors, progesterone.


Abstrak

Latar Belakang Leiomioma uteri adalah tumor jinak pada wanita usia reproduksi
yang paling sering ditemukan berasal dari otot polos miometrium uterus. Pertumbuhan
mioma uteri terkait dengan estrogen dan reseptornya. Pertumbuhan leiomioma
dipengaruhi oleh interaksi progesteron dengan beberapa faktor pertumbuhan.
Progesteron mengatur EGF (mitogenik) dan merubah faktor pertumbuhan (TGF-)β3.
Pertumbuhan mioma adalah keseimbangan antara proliferasi sel dan apoptosis, efek
progesteron pada apoptosis adalah meningkatkan ekspresi protein anti-apoptosis Bcl-2
(Sel limfoma B).
Objektif: Untuk mengetahui kadar kepadatan reseptor progesteron pada leiomioma
dan pada miometrium normal.
Metode: Penelitian ini merupakan suatu penelitian cross sectional dengan metode
desktriptif analitik, dengan melakukan pemeriksaan secara imunohistokimia untuk
mendeteksi reseptor progesteron pada jaringan leiomioma uteri dan miometrium
normal yang diambil dari penderita yang sama setelah menjalani histerektomi di RSUP
Prof. Dr. R.D. Kandou Manado dan rumah sakit jejaring di Manado sejak bulan
November 2017 sampai dengan bulan Januari 2018.
Hasil: Karakteristik responden yang paling banyak berdasarkan usia pasien adalah
usia di atas 46 yaitu 10 orang (62.5%). Berdasarkan status haid, mayoritas sampel
sudah memasuki masa menopause yaitu 9 orang (56.25%). Berdasarkan lokasi
leiomioma, terbanyak responden memiliki mioma intramural yaitu 14 orang (87.5%),
sedangkan berdasarkan keluhan menstruasi, terbanyak responden memiliki HMB
yaitu 12 orang (75%).Berdasarkan hasil uji statistik dengan metode Mann – Whitney,
hasil nilai p=0,000 (p < 0,05). Hal ini menunjukan bahwa terdapat perbedaan
bermakna antara reseptor progesteron jaringan normal dan reseptor progesteron
leiomioma pada uterus yang sama.
Kesimpulan: Pertumbuhan mioma uteri terkait dengan estrogen, progesteron dan
reseptornya. Kepadatan progesteron pada leiomioma lebih tinggi dibandingkan pada
miometrium normal dan terdapat perbedaan bermakna secara statistik. Pertumbuhan
leiomioma dipengaruhi oleh interaksi progesteron dengan beberapa faktor pertumbuhan
(Growth Factor).

Kata Kunci: leiomioma, reseptor, progesteron.

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