Association between folate status and cervical intraepithelial neoplasia

Abstract

Background/Objectives:To investigate the effect of folate status on cervical intraepithelial neoplasia (CIN) progression and its relationship with high-risk human papillomavirus (hrHPV).Subjects/Methods:We evaluated 20 000 sexually active women aged <65 years in Yangqu County by using a questionnaire; the subjects were also screened using the ThinPrep cytologic test (TCT). Patients with abnormal TCT results (other than glandular cell abnormalities) who were willing to provide informed consent were further diagnosed using colposcopy and histopathological examination. We investigated 247 cases of low-grade cervical squamous intraepithelial lesions (LSIL), 125 cases of high-grade cervical squamous intraepithelial lesions (HSIL) and 877 controls. A 24-item food frequency questionnaire was filled out by the investigator to estimate the consumption of dietary folate. Positivity for hrHPV from residual exfoliated cervical cells was tested; serum folate was also measured.Results:The hrHPV infection rate in HSIL patients (77.6%) was higher than that in LSIL (33.2%) and control (32.0%) patients. Dietary folate intakes in controls, LSIL and HSIL were 306.9±176.6, 321.8±168.0 and 314.7±193.8 μg/kcal, respectively. The levels of serum folate in controls, LSIL and HSIL were 18.2±7.9, 15.9±7.1 and 14.3±7.5 nmol/l, respectively. Increased CIN correlated with higher rates of hrHPV infection and lower levels of serum folate.Conclusions:Low levels of serum folate may increase the risk of CIN progression. Furthermore, potential synergy may exist between low serum folate levels and hrHPV infection to promote CIN development.

Predictive value of p16INK4a, Ki‑67 and ProExC immuno‑qualitative features in LSIL progression into HSIL

“…Among human papillomavirus (HPV)-infected individuals, only 1% will progress to cervical cancer (8)(9)(10)(11). Investigations into the relationship between HPV and the host cell cycle have identified a number of biomarkers, including cyclin-dependent kinase inhibitor 2A (p16 INK4a ), marker of proliferation Ki-67 (Ki-67) and immunohistochemical cocktail containing antibodies direct against topoisomerase IIα (TOP2A) and minichromosome maintenance 2 (MCM2) proteins (ProExC), which can be measured to improve the detection and grading of HPV-associated SIL, as they were found to be overexpressed in HPV-infected cells (12).…”

Cervical Intraepithelial Neoplasia and Cervical Cancer. Is Human Papillomavirus the Only Risk Factor?

“…Поскольку CIN -это динамический процесс, то может наблюдаться и регрессия, и прогрессия дисплазий. CIN I регрессирует в 90% случаев [2], тогда как CIN II и CIN III только в 40 и 33% случаев соответственно [3]. CIN…”

Dietary nutrient intake related to higher grade cervical intraepithelial neoplasia risk: A Chinese population-based study

“…A previous study found no association between dietary folate intake and CIN risk [19]. However, other studies observed con icting results [20], [21], [22]. Vitamin B6 reportedly aids in the regulation of the immune system, which is associated with cancer risk [23].…”

“…The previous study showed that the intake of folate-rich food could reduce cervical cancer risk [34]. The plasma nutrient concentrations among the residents of Shanxi are lower than those among people from other areas [21]. It is unclear whether dietary nutrition intake can affect CIN incidence.…”