Zhu J J, Wang J T, Gong L, Ran Z X, Guo C Y, Song L, Lyu Y J, Ding L
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2022 Apr 6;56(4):453-458. doi: 10.3760/cma.j.cn112150-20210906-00869.
To evaluate the relationship between red blood cell folate (RBC folate) and the prognosis of low-grade cervical intraepithelial neoplasia (CIN 1). In the married women cohort established in 2014, 564 women with CIN 1 diagnosed by pathology were recruited. The demographic characteristics and factors of cervical intraepithelial neoplasia were collected. Meanwhile, the infection status of human papillomavirus (HPV) was detected by molecular diversion hybridization, and the level of RBC folate was measured by chemical photoimmunoassay. After 24 months of follow-up, pathological examination was performed again to observe the prognosis of participants. The women with reversal were taken as the control group,and those with continuous and progressive CIN 1 were taken as the case group respectively. The relationship between RBC folate and CIN 1 outcome was evaluated by logistic regression model. 453 women completed the follow-up, aged (49.72±6.84) years old. CIN 1 was reversed in 342 women, continued in 58 cases and progressed in 53 cases. The RBC folate level () were 399.01 (307.10, 538.97) ng/ml, 316.98 (184.74, 428.49) ng/ml and 247.14 (170.54, 348.97) ng/ml, respectively. With the decrease of RBC folate, the risk of continuous and progressive CIN 1 increased (all <0.001), while the risk of reversal CIN 1 decreased gradually (<0.001). Combined with high-risk human papillomavirus (HR-HPV) infection status, low level of RBC folate could increase the risk of CIN 1 progression regardless of HR-HPV infection (HR-HPV infection: =21.34, 95%: 3.98-114.54; HR-HPV uninfection: =11.15, 95%: 2.34-53.13). Low level of RBC folate could increase the risk of CIN 1 persistence and progression regardless of HR-HPV infection.
评估红细胞叶酸(RBC叶酸)与低级别宫颈上皮内瘤变(CIN 1)预后之间的关系。在2014年建立的已婚女性队列中,招募了564例经病理诊断为CIN 1的女性。收集其人口统计学特征及宫颈上皮内瘤变相关因素。同时,采用分子导流杂交法检测人乳头瘤病毒(HPV)感染状况,采用化学发光免疫分析法测定RBC叶酸水平。随访24个月后,再次进行病理检查以观察参与者的预后情况。将病情逆转的女性作为对照组,病情持续及进展的CIN 1患者分别作为病例组。采用logistic回归模型评估RBC叶酸与CIN 1转归之间的关系。453例女性完成随访,年龄为(49.72±6.84)岁。342例女性的CIN 1病情逆转,58例持续,53例进展。其RBC叶酸水平()分别为399.01(307.10,538.97)ng/ml、316.98(184.74,428.49)ng/ml和247.14(170.54,348.97)ng/ml。随着RBC叶酸水平降低,CIN 1持续及进展的风险增加(均P<0.001),而CIN 1逆转的风险逐渐降低(P<0.001)。结合高危人乳头瘤病毒(HR-HPV)感染状况,无论HR-HPV感染与否,低水平RBC叶酸均可增加CIN 1进展风险(HR-HPV感染:OR=21.34,95%CI:3.98-114.54;HR-HPV未感染:OR=11.15,95%CI:2.34-53.13)。无论HR-HPV感染与否,低水平RBC叶酸均可增加CIN 1持续及进展的风险。