Hubungan Kadar Prostaglandin E2 dan Interleukin-6 dengan Derajat Nyeri dan Stadium Endometriosis

Endometriosis is a chronic gynecological disease characterized by pelvic pain and persistent inflammatory processes. Prostaglandin E2 (PGE2) and Interleukin-6 (IL-6) are inflammatory mediators involved in peripheral and central pain sensitization as well as disease progression. However, their association with clinical indicators such as pain severity and disease stage remains inconsistent. This study aimed to determine the relationship between PGE2 and IL-6 levels in peritoneal lavage fluid with pain severity and endometriosis stage. This analytical observational study with a cross-sectional design included 25 endometriosis patients scheduled for laparoscopic surgery at Arifin Achmad General Hospital, Pekanbaru. Peritoneal lavage fluid samples were collected intraoperatively and analyzed using ELISA. Pain severity was assessed using the Visual Analog Scale (VAS), while endometriosis staging was classified according to ASRM criteria. Statistical analysis was conducted using the Kruskal–Wallis test and Spearman correlation. Mean PGE2 levels increased progressively with pain severity (317.38 pg/mL in mild pain; 547.97 pg/mL in moderate pain; 766.55 pg/mL in severe pain), showing a strong positive correlation (r = 0.764; p = 0.001). IL-6 levels showed no significant association with pain severity (r = –0.287; p = 0.296). Regarding endometriosis staging, IL-6 demonstrated a very strong positive correlation (r = 0.947; p < 0.001), whereas PGE2 showed a weak and non-significant negative correlation (p = 0.386). PGE2 levels are significantly associated with pain severity, while IL-6 levels are significantly associated with endometriosis stage. These findings highlight the potential of PGE2 and IL-6 as complementary biomarkers for assessing pain and disease progression in endometriosis.

Endometriosis, Prostaglandin E2, Interleukin-6, Pain Severity, Disease Stage. ABSTRAK Endometriosis merupakan penyakit ginekologis kronis yang ditandai oleh nyeri panggul dan proses inflamasi berkelanjutan. Prostaglandin E2 (PGE2) dan Interleukin-6 (IL-6) merupakan mediator inflamasi yang berperan dalam proses sensitisasi nyeri perifer dan sentral serta progresivitas penyakit. Namun, hubungan keduanya dengan indikator klinis seperti derajat nyeri dan stadium endometriosis masih belum konsisten. Penelitian ini bertujuan untuk mengetahui hubungan kadar PGE2 dan IL-6 dalam cairan bilasan peritoneum dengan derajat nyeri dan stadium endometriosis. Penelitian analitik observasional dengan desain cross sectional dilakukan pada 25 pasien endometriosis yang direncanakan tindakan laparaskopi di RSUD Arifin Achmad, Pekanbaru. Sampel cairan bilasan peritoneum diambil selama tindakan laparoskopi dan dianalisis menggunakan metode ELISA. Derajat nyeri dinilai dengan Visual Analog Scale (VAS), sementara stadium endometriosis diklasifikasikan berdasarkan kriteria ASRM. Analisis statistik menggunakan uji Kruskal–Wallis dan korelasi Spearman. Rerata kadar PGE2 meningkat seiring peningkatan derajat nyeri (317,38 pg/mL pada nyeri ringan; 547,97 pg/mL pada nyeri sedang; 766,55 pg/mL pada nyeri berat), dengan korelasi positif kuat (r = 0,764; p = 0,001). Kadar IL-6 tidak menunjukkan hubungan bermakna dengan derajat nyeri (r = –0,287; p = 0,296). Pada stadium endometriosis, IL-6 menunjukkan korelasi positif sangat kuat (r = 0,947; p < 0,001), sedangkan PGE2 menunjukkan korelasi negatif lemah yang tidak signifikan (p = 0,386). Kadar PGE2 memiliki hubungan bermakna dengan derajat nyeri, sedangkan kadar IL-6 berhubungan bermakna dengan stadium endometriosis. Temuan ini menunjukkan potensi PGE2 dan IL-6 sebagai biomarker komplementer dalam evaluasi nyeri dan progresivitas endometriosis. Kata Kunci: Endometriosis, Prostaglandin E2, Interleukin-6, Derajat Nyeri, Stadium Endometriosis. Kata Kunci Teks Lengkap: Download Artikel.Referensi Aris, A., et al. (2024). Characteristics of endometriosis patients in reproductive age women. Journal of Obstetrics and Gynecology Research, 50(2), 115–122. Andrieu, T., et al. (2022). Endocannabinoids and prostaglandin pathways in endometriosis-associated pain. Reproductive Sciences, 29(8), 2145–2154. Clark, T. J. (2008). Prostaglandins and menstrual physiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(2), 273–285. Fatimah, S., et al. (2018). Profil pasien endometriosis di RSUD Arifin Achmad Provinsi Riau. Jurnal Kesehatan Melayu, 2(1), 45–52. Garmendia, M. L., et al. (2025). Interleukin-6 signaling and chronic inflammation in endometriosis progression. Frontiers in Immunology, 16, 102311. Gu, X., et al. (2022). Prostaglandin E2 promotes endometriosis progression through angiogenesis and aromatase activation. International Journal of Molecular Sciences, 23(5), 2514. Jenabi, E. (2021). Parity and risk of endometriosis: A meta-analysis. International Journal of Fertility & Sterility, 15(1), 1–7. Machairiotis, N., et al. (2021a). Inflammation and pain pathways in endometriosis. Biomedicines, 9(5), 495. Machairiotis, N., et al. (2021b). COX-2 and prostaglandin pathways in endometriosis progression. International Journal of Molecular Medicine, 47(3), 1–10. Meng, X., et al. (2021). Correlation of peritoneal PGE2 with pain severity in endometriosis. BMC Women’s Health, 21(1), 88. Prima, V., et al. (2021a). Interleukin-6 and severity of endometriosis in Indonesian women. Majalah Obstetri & Ginekologi Indonesia, 45(3), 167–174. Prima, V., et al. (2021b). Correlation between IL-6 and pain score in endometriosis patients. Indonesian Journal of Obstetrics and Gynecology, 9(2), 101–108. Rakhila, H., et al. (2015). Expression of prostaglandin receptors in endometriosis-associated pain. Human Reproduction, 30(5), 1222–1230. Ricciotti, E., & FitzGerald, G. A. (2020). Prostaglandins and inflammation. Arteriosclerosis, Thrombosis, and Vascular Biology, 31(5), 986–1000. Rowlands, I. J., et al. (2022). Body mass index and risk of endometriosis. Human Reproduction Update, 28(3), 345–357. Velasco, I., et al. (2010). Cytokine profile in endometriosis-associated pain. Fertility and Sterility, 94(3), 1091–1096. Wei, M., et al. (2020). Autonomic nervous system imbalance and inflammatory cytokines in endometriosis. Journal of Neuroinflammation, 17(1), 214. Wu, M. H., et al. (2020). Peritoneal prostaglandin E2 levels and endometriosis stage. Fertility and Sterility, 114(4), 845–852. Yadav, P., et al. (2021). Endometrial proliferative phase and estrogen receptor expression in endometriosis. Reproductive Biology and Endocrinology, 19(1), 88. Zhou, W., et al. (2020). IL-6 levels in peritoneal fluid among women with endometriosis. Cytokine, 127, 154950. DOI: https://doi.org/10.33024/mnj.v8i10.26265 Refbacks - Saat ini tidak ada refbacks.