Electronic Theses and Dissertation

Latar Belakang: Endometriosis merupakan kondisi patologis yang ditandai dengan keberadaan jaringan mirip endometrium di luar kavum uteri, mempengaruhi sekitar 10% wanita usia reproduksi. Interleukin-6 (IL-6) dan Cancer Antigen 125 (CA-125) merupakan biomarker yang diduga berperan dalam patogenesis endometriosis, namun penelitian mengenai hubungan simultan keduanya dengan stadium penyakit dan intensitas nyeri masih terbatas, terutama pada populasi Indonesia. Penelitian ini bertujuan menganalisis hubungan kadar IL-6 cairan peritoneal dan CA-125 serum dengan stadium endometriosis dan derajat nyeri pada pasien endometriosis.
Metode: Penelitian ini merupakan studi analitik observasional dengan desain potong lintang melibatkan 32 pasien endometriosis yang menjalani laparoskopi atau laparotomi di RSUD Dr. Zainoel Abidin, Banda Aceh dari Mei sampai dengan Juli 2025. Kadar IL-6 cairan peritoneal dan CA-125 serum diukur menggunakan metode ELISA. Stadium endometriosis diklasifikasikan berdasarkan kriteria ASRM, sementara derajat nyeri dinilai menggunakan Numeric Rating Scale (NRS). Analisis statistik meliputi uji korelasi Spearman, regresi logistic dan analisis kurva ROC. Hasil: Terdapat korelasi positif bermakna antara kadar IL-6 cairan peritoneal dengan stadium endometriosis (r=0,387; p=0,029), namun tidak berkorelasi dengan derajat nyeri (r=0,146; p=0,425). Kadar CA-125 serum berkorelasi positif bermakna dengan stadium endometriosis (r=0,514; p=0,003) dan derajat nyeri (r=0,420; p=0,017). Tidak ditemukan korelasi bermakna antara IL-6 dan CA-125 (r=0,190; p=0,297). Analisis multivariat menunjukkan hanya CA-125 yang merupakan prediktor independen untuk stadium endometriosis berat (OR=2,837; 95% CI=1,139-7,069; p=0,025). Nilai cut-off optimal IL-6 cairan peritoneal untuk memprediksi stadium endometriosis berat adalah 82,15 pg/mL (sensitivitas 54,2%, spesifisitas 62,5%), sedangkan CA-125 serum adalah 90,67 U/mL (sensitivitas 62,5%, spesifisitas 87,5%).
Kesimpulan: CA-125 serum memiliki korelasi lebih kuat dibandingkan IL-6 cairan peritoneal dengan stadium endometriosis dan merupakan prediktor independen untuk stadium endometriosis berat. CA-125 juga berkorelasi dengan derajat nyeri, sementara IL-6 tidak. Temuan ini mendukung penggunaan CA-125 sebagai biomarker utama dalam menilai keparahan endometriosis, sedangkan IL-6 mungkin memberikan informasi komplementer yang dapat melengkapi penilaian klinis endometriosis.

Kata Kunci: Endometriosis, Interleukin-6, CA-125, Stadium Endometriosis, Derajat Nyeri

Background: Endometriosis is a pathological condition characterized by the presence of endometrium-like tissue outside the uterine cavity, affecting approximately 10% of women of reproductive age. Interleukin-6 (IL-6) and Cancer Antigen 125 (CA-125) have been proposed as potential biomarkers in the pathogenesis of endometriosis, but research on their simultaneous relationship with disease stage and pain intensity remains limited, especially in the Indonesian population. This study aimed to analyze the relationship between peritoneal fluid IL-6 levels and serum CA-125 levels with endometriosis stage and pain severity in endometriosis patients. Methods: This observational analytical study with cross-sectional design involved 32 endometriosis patients who underwent laparoscopy or laparotomy at Dr. Zainoel Abidin Regional Hospital, Banda Aceh from May to July 2025. Peritoneal fluid IL-6 and serum CA-125 levels were measured using ELISA method. Endometriosis stage was classified according to ASRM criteria, while pain severity was assessed using the Numeric Rating Scale (NRS). Statistical analysis included Spearman correlation test, logistic regression and ROC curve analysis. Results: There was a significant positive correlation between peritoneal fluid IL-6 levels and endometriosis stage (r=0.387; p=0.029), but no correlation with pain severity (r=0.146; p=0.425). Serum CA-125 levels showed significant positive correlations with both endometriosis stage (r=0.514; p=0.003) and pain severity (r=0.420; p=0.017). No significant correlation was found between IL-6 and CA-125 levels (r=0.190; p=0.297). Multivariate analysis showed that only CA-125 was an independent predictor for severe endometriosis stage (OR=2.837; 95% CI=1.139- 7.069; p=0.025). The optimal cut-off value of peritoneal fluid IL-6 for predicting severe endometriosis stage was 82.15 pg/mL (sensitivity 54.2%, specificity 62.5%), while for serum CA-125 it was 90.67 U/mL (sensitivity 62.5%, specificity 87.5%). Conclusion: Serum Ca-125 has a stronger correlation than peritoneal fluid IL-6 with endometriosis stage and serves as an independent predictor for severe endometriosis stage. Ca-125 also correlates with pain severity, while IL-6 does not. These findings support the use of Ca-125 as a primary biomarker in assessing endometriosis severity, while IL-6 may provide complementary information that can supplement the clinical assessment of endometriosis Keywords: Endometriosis, Interleukin-6, CA-125, Endometriosis Stage, Pain Severity