SERVİKS KARSİNOMU VE YÜKSEK DERECELİ SKUAMOZİNTRAEPİTELYAL LEZYONLARDA SERUM FOLAT, VİTAMİN B12,HOMOSİSTEİN VE ESER ELEMENT DÜZEYLERİ

Yıl 2013, Cilt: 16 Sayı: 2, 39 - 43, 01.04.2013

Müjdegül Zayıfoğlu Karaca Cihan Toğrul Eralp Başer Bülent Özdal Tayfun Güngör

Öz

Objective: To determine folate, vitamin B12, homocysteine, trace
elements (zinc, copper, iron), serum iron binding capacity and ferritin
levels in cervical cancer and high grade squamous intraepithelial lesion
(HSIL) patients.
Material and Methods: HSIL and cervical cancer patients, who
treated in our gynecologic oncology unit between 2008-2011, were investigated
retrospectively.Fifty-four patient were in HSIL group and
65 were in cervical cancer group. Folate, vitamin B12, homocysteine,
trace elements (zinc, copper, iron), serum iron binding capacity and
ferritin levels, patients age, diagnosis were recorded.
Results: There was no statistical significant difference in zinc,
iron, folate, B12 levels between HSIL and cervical cancer groups
(p>0.05). Copper, serum iron binding capacity, ferritin, homocysteine
levels were significantly different between two groups (p<0.05). Between
different age groups (under 50 and above 50 years) there were
significant difference in serum iron binding capacity, ferritin, homocysteine
levels (p<0.001). However, no statistical significant difference in
zinc, copper, folate, iron, B12 levels between two age groups were detected.
(p>0.05).
Conclusion: Future trials are needed to determine the role of serum
trace elements, folate, vitamin B12 and homocystein levels in development
of cervical preinvasive lesions and carcinogenesis.

Anahtar Kelimeler

Cervical Cancer, High Grade Squamous Intraepithelial Lesion, Vitamin B12, Folate, Homocystein, Trace Element.

SERVİKS KARSİNOMU VE YÜKSEK DERECELİ SKUAMOZİNTRAEPİTELYAL LEZYONLARDA SERUM FOLAT, VİTAMİN B12,HOMOSİSTEİN VE ESER ELEMENT DÜZEYLERİ

Öz

Amaç: Serviks kanseri ve yüksek dereceli skuamoz intraepitelyal
lezyon(HSIL) tanısı alan hastalarda folat, vitamin B12 , homosistein,
eser element çinko, bakır, demir), serum demir ba¤lama kapasitesi ve
ferritin düzeylerinin karşılaştırılması.
Materyal ve Metod: Hastanemiz jinekolojik onkoloji klini¤inde
2008-2011 yılları arasında takip ve tedavisi yapılan HSIL ve serviks
karsinomu olguları retrospektif olarak incelendi. Elli dört olgu HSIL ,
65 olgu ise serviks kanseri tanısı almıştı. Olguların yaşı, biyopsi tanı-
sı, serum eser elementleri (çinko, bakır, demir), folat, vitamin B12, ferritin,
homosistein düzeyleri ile serum demir ba¤lama kapasitesi
(SDBK) kaydedilerek karşılaştırıldı. Olgular ayrıca yaşlarına göre
gruplandırılarak karşılaştırıldı.
Sonuçlar: Grupların çinko, demir, folat ve B12 ortalamaları arasında
istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Bakır,
SDBK, ferritin ve homosistein düzeyleri arasında anlamlı fark saptandı
(p<0.05). Yaş gruplarına göre, Grup 1(< 50) ile Grup 2 (50 yaş üstü)
arasında, SDBK, ferritin, homosistein de¤erleri ortalamaları arasında
anlamlı fark saptandı (p<0.001). Çinko, bakır, demir, folat, B12 de¤erleri
ortalamaları arasında anlamlı fark yoktu (p>0.05).
Sonuç: Serum eser elementleri, folat, vitamin B12 ve homosistein
düzeylerinin preinvaziv lezyon oluşumu ve servikal karsinogenezdeki
rolünün ortaya konulabilmesi için gelecek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Serviks Kanseri, Yüksek Dereceli Skuamoz İntraepitelyal Lezyon, Vitamin B12, Folat, Homosistein, Eser Element

Kaynakça

• 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61 (2):69-90. doi:caac.20107 (pii) 10.3322/caac.20107.
• 2. Schiffman MH, Castle P (2003) Epidemiologic studies of a necessary causal risk factor: human papillomavirus infection and cervical neoplasia. J Natl Cancer Inst 95 (6):E2.
• 3. Ostor AG (1993) Natural history of cervical intraepithelial neoplasia: a critical review. Int J Gynecol Pathol 12 (2):186-192.
• 4. Butterworth CE, Jr. (1992) Effect of folate on cervical cancer. Synergism among risk factors. Ann N Y Acad Sci 669:293-299.
• 5. Mason JB, Levesque T (1996) Folate: effects on carcinogenesis and the potential for cancer chemoprevention. Oncology (Williston Park) 10 (11):1727-1736, 1742-1723; discussion 1743-1724.
• 6. Hoffbrand AV, Weir DG (2001) The history of folic acid. Br J Haematol 113 (3):579-589. doi:bjh2822 (pii).
• 7. Alberg AJ, Selhub J, Shah KV, Viscidi RP, Comstock GW, Helzlsouer KJ (2000) The risk of cervical cancer in relation to serum concentrations of folate, vitamin B12, and homocysteine. Cancer Epidemiol Biomarkers Prev 9 (7):761-764.
• 8. Flynn MA, Herbert V, Nolph GB, Krause G (1997) Atherogenesis and the homocysteine-folate-cobalamin triad: do we need standardized analyses? J Am Coll Nutr 16 (3):258-267.
• 9. Weinstein SJ, Ziegler RG, Selhub J, Fears TR, Strickler HD, Brinton LA, Hamman RF, Levine RS, Mallin K, Stolley PD (2001) Elevated serum homocysteine levels and increased risk of invasive cervical cancer in US women. Cancer Causes Control 12 (4):317-324.
• 10. Martin-Lagos F, Navarro-Alarcon M, Terres-Martos C, Lopez GdlSH, Lopez-Martinez MC (1997) Serum copper and zinc concentrations in serum from patients with cancer and cardiovascular disease. Sci Total Environ 204 (1):27-35. doi:S0048969797001630 (pii).
• 11. Lowndes SA, Adams A, Timms A, Fisher N, Smythe J, Watt SM, Joel S, Donate F, Hayward C, Reich S, Middleton M, Mazar A, Harris AL (2008) Phase I study of copper-binding agent ATN-224 in patients with advanced solid tumors. Clin Cancer Res 14 (22):7526-7534.
• doi:14/22/7526 (pii) 10.1158/1078-0432.CCR-08-0315 12. Wu T, Sempos CT, Freudenheim JL, Muti P, Smit E (2004) Serum iron, copper and zinc concentrations and risk of cancer mortality in US adults. Ann Epidemiol 14 (3):195-201. doi:10.1016/S1047-2797(03)00119-4 S1047279703001194 (pii).
• 13. Poljak-Blazi M, Jaganjac M, Sabol I, Mihaljevic B, Matovina M, Grce M (2011) Effect of ferric ions on reactive oxygen species formation, cervical cancer cell lines growth and E6/E7 oncogene expression. Toxicol In Vitro 25 (1):160-166. doi:S0887-2333(10)00271-7 (pii) 10.1016/j.tiv.2010.10.013.
• 14. Lee DH, Zacharski LR, Jacobs DR, Jr. (2006) Comparison of the serum ferritin and percentage of transferrin saturation as exposure markers of iron-driven oxidative stress-related disease outcomes. Am Heart J 151 (6):1247 e1241-1247. doi:S0002-8703(06)00266-3 (pii) 10.1016/j.ahj.2006.03.009.
• 15. Stevens RG, Cologne JB, Nakachi K, Grant EJ, Neriishi K (2011) Body iron stores and breast cancer risk in female atomic bomb survivors. Cancer Sci 102 (12):2236- 2240. doi:10.1111/j.1349-7006.2011.02080.x
• 16. Cross AJ, Sinha R, Wood RJ, Xue X, Huang WY, Yeager M, Hayes RB, Gunter MJ (2011) Iron homeostasis and distal colorectal adenoma risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Prev Res (Phila) 4 (9):1465-1475. doi:1940-6207.CAPR11-0103 (pii) 10.1158/1940-6207.CAPR-11-0103