Servikal İntraepithelial Lezyonlarda Demografik Özellikler, Folat, Vitamin B12 ve Vitamin D Serum Seviyeleri

Öz

Amaç: Serviks kanseri gelişiminde Human papilloma virüs HPV en önemli faktör olmakla beraber bu süreçte kofaktörler de rol oynamaktadır. Çalışmamızda, servikal intraepithelial lezyonlarda demografik özellikleri, folat, B12 vitamini, D vitamini serum seviyelerini araştırdık.Gereç ve Yöntemler: Çalışmaya kolposkopi yapılan ve folat, B12 vitamini ve D vitamini serum düzeyleri ölçülmüş hastalar dahil edildi. Histoloji sonuçlarına göre hastalar, servikal intraepitelyal neoplazi derece 1 veya normal ≤ CIN 1 ve servikal intraepitelyal neoplazi derece 2 veya daha yüksek anormallikler ≥ CIN 2 olan iki gruba ayrıldı. Bu iki grup arasında, hastaların yaşı, paritesi, abortus sayısı, menopozal durumu, sigara kullanımı, rahim içi araç kullanımı, postkoital kanama şikayeti gibi demografik özelliklerinin yanı sıra, folat, B12 vitamini ve D vitamini serum seviyeleri karşılaştırıldı.Bulgular: 83 hasta çalışma kapsamında değerlendirildi. Hastaların ortanca yaşı 41 idi ve 22ʼsi %26,5 hâlen sigara içiyordu. Hastaların hiçbiri herhangi bir vitamin veya folik asit takviyesi almıyordu. Histoloji sonuçlarının en yüksek derecesine göre; 67 %80,7 hastada ≤ CIN 1 ve 16 %19,3 hastada ≥ CIN 2 lezyonu tespit edildi. Serum folat, B12 vitamini ve D vitamini düzeyleri gruplar arasında farklılık göstermedi. Mevcut sigara kullanımı ≥ CIN 2 lezyonlarının ortaya çıkmasına bağlı olan tek parametre idi %36,4'e karşılık %13,1; p=0,018 . Ayrıca, ≥ CIN 2 lezyonlarının ortaya çıkmasının sigara içme süresi ile arttığı belirlendi p=0,031 . Sonuç: Folat, B12 ve D vitaminleri, vücutta ortalama veya subnormal seviyelerde bulunduğunda ≥ CIN 2 lezyonları için risk faktörü değildir. Sigara kullanımı, serviks kanseri gelişiminde önemli bir kofaktördür. Risk, sigara kullanım süresi ile artmaktadır. Hastalara sigara kullanımının sonlandırılması önerilmelidir

Anahtar Kelimeler

• Serviks kanseri, Folat, Vitamin B12, Vitamin D, Sigara

Demographic Characteristics and the Folate, Vitamin B12 and Vitamin D Serum Levels in Cervical Intraepithelial Lesions

Abstract

Objective: Human papillomavirus HPV infection is necessary but not sufficient for the development of cervical cancer, and some other factors are known to play a role in this progression. Here, we aimed to investigate the serum levels of folate, vitamin B12, and vitamin D, and the demographic characteristics in cervical cancer precursor lesions.Material and Methods: Patients who had undergone colposcopy and tested for the serum levels of folate, vitamin B12, and vitamin D were included in this study. Based on histological outcomes, patients were grouped as those with cervical intraepithelial neoplasia grade 1 or lesser abnormalities ≤ CIN 1 and those with cervical intraepithelial neoplasia grade 2 or higher abnormalities ≥ CIN 2 . Among these two groups, patients were compared in terms of demographic characteristics such as age; parity; abortus number; menopausal status; smoker status; use of intrauterine devices; postcoital bleeding complaint and the serum levels of folate, vitamin B12, and vitamin D.Results: 83 patients were enrolled in the present study. The median age of the study population was 41 years and 22 patients 26.5% were currently smokers. None of the patients were using any vitamin or folate supplements. According to the highest grade of histology outcomes; 67 80.7% patients had ≤ CIN 1 and 16 19.3% patients had ≥ CIN 2 lesions. The serum levels of folate, vitamin B12, and vitamin D did not differ between the groups. Current smoking was the only parameter related with the occurrence of ≥ CIN 2 lesions 36.4% vs. 13.1%; p=0.018 . In addition, the occurrence of ≥ CIN 2 lesions increased with the duration of smoking p=0.031 .Conclusion: Folate, and vitamins B12 and D are not risk factors for ≥ CIN 2 lesions when present at average or subnormal levels. Current smoking is a cofactor for the occurrence of ≥ CIN 2 lesions. Thus, the risk increases with the duration of smoking. Smoking cessation should be suggested in women with cervical premalignant lesions

Keywords

• Cervical cancer, Folate, Vitamin B12, Vitamin D, Smoking

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