Hubungan Imunoekspresi Annexin V (ANX V) dengan Histopatologi Jaringan Kuretase pada Abortus Berulang

Abstract

   ABSTRACT Background : Abortion the ending of pregnancy due to removing an embryo or fetus before it can survive outside the uterus. Examination on placental tissue currently does not provide much information. Annexin V (ANX V), formerly known as placenta anticoagulant protein and alpha coagulant vascular, is found in the placenta and vascular endothelium and several other tissues. This ANX V is found at the top of the placenta syncytiotrophoblast, and it is also found that this protein content freely decreases with the antiphospholipid syndrome (APS). This study aimed to assess the relationship between the description of ANX V expression and histopathology of curettage tissue in patients with recurrent abortion. Methods : This study was conducted using curettage tissue samples of patients with recurrent abortion in the Obstetrics and Gynecology section of Abdul Manap Hospital and Baiturahim Hospital in February to August 2018. The collected samples were diagnosed with HE preparations, to determine histopathological features in each group, villi infarction. hydrophic villi, sincytial knots, fibrin stroma and inter villi thrombus with the highest total score were 15. Then immunohistochemical assessment with Annexin V (ANX V) results compared with positive controls and negative controls with cut-off points 10%. Results: We have found a recurrent abortion sample with positive Annexin V immunoexpression, which is the most common histopathological score of 11-15 on recurrent abortion (p = 0.001 and r = -0.784) Conclusion: There is a relationship between immunohistochemistry ANX V with histopathological features of recurrent abortion curettage. Keywords: Annexin V, Histopathology, Recurrent abortion   ABSTRAK Latar Belakang: Abortus adalah keadaan pengeluaran hasil konsepsi sebelum janin dapat hidup di luar kandungan. Pemeriksaan pada jaringan plasenta saat ini tidak banyak memberikan informasi. Annexin V (ANX V), dulu dikenal dengan placental  anticoagulant protein I dan vascular coagulant alfa,   ditemukan di plasenta dan endotel vaskular dan beberapa jaringan yang lain. ANX V ini ditemukan di puncak permukaan sinsitiotrofoblas plasenta, dan  ditemukan pula bahwa kadar protein ini secara bermakna menurun di villi plasenta penderita abortus dengan antiphospholipid syndrome (APS). Penelitian ini bertujuan melihat hubungan gambaran ekspresi ANX V dengan histopatologi jaringan kuretase  pada penderita abortus berulang. Metode : Penelitian ini dilakukan dengan menggunakan sampel jaringan kuretase pasien abortus berulang di bagian Obstetri dan Ginekologi RS Abdul manap dan RS Baiturahim periode februari sampai agustus 2018. Sampel yang terkumpul dilakukan diagnosis terhadap sediaan HE, untuk menetukan gambaran histopatologis  pada masing-masing kelompok yaitu infark villi, hidrofik villi,  sincytial knots, fibrin stroma serta trombus inter villi dengan skor total tertinggi adalah 15. Kemudian dilakukan pemulasan dan penilaian imunohistokimia dengan Annexin V (ANX V) Hasil pulasan imunohistokimia Anti ANX V dibandingkan dengan kontrol positif dan kontrol negative dengan cut-off point 10%. Hasil: Didapatkan 30 sampel abortus berulang dengan imunoekspresi Annexin V positif, didapatkan paling banyak dengan skor histopatologi 11- 15  pada abortus berulang  (p = 0.001 and r = -0.784). Kesimpulan: Terdapat hubungan antara imunohistokimia ANX V dengan gambaran histopatologi pada kuretase abortus berulang. Kata Kunci: Annexin V, Histopatologi, Abortus berulang