Study On The Relationship Between Serum And Red Blood Cell Folate Levels And Different Grades Of Cervical Lesion

Objective:The relationship between serum folic acid,erythrocyte folic acid and cervical carcinogenesis was systematically evaluated.Methods:Through the keywords such as "serum folic acid,erythrocyte folic acid,cervical cancer,cervical lesion",the CNKI,Wan Fang Data,VIP,PubMed,Cochrane,Embase and other databases were searched by computer.the search time was from self-built database to May 2021.According to the inclusion and exclusion criteria,there were two researchers independently screened the literature,and collected and extracted all case-control studies on the relationship between serum levels and cervical canceration.Two evaluators independently screened the literature,extracted data,and evaluated the bias risk of the included study,then used ReviewManager5.3 software for statistical analysis.Results:Finally,13 literatures and 13 case-control studies were included,including 3958 cases of low cervical squamous intraepithelial lesion,334 cases of high cervical squamous intraepithelial lesion,1229 cases of cervical cancer and 2091 cases of control group(women with normal or cervicitis).The results of Meta analysis show that:The results of Meta analysis show that:1.The levels of serum and erythrocyte folic acid in patients with LSIL cases,HSIL cases and cervical cancer were lower than those in the control group(P<0.05).The degree of decrease was statistically significant(P<0.05).2.The levels of serum and erythrocyte folic acid in patients with HSIL were significantly lower than those in patients with LSIL(P<0.05).3.With the deepening of the degree of cervical lesions,the decrease of serum and erythrocyte folic acid levels increased.Conclusion:There was a negative correlation between serum folic acid level,erythrocyte folic acid and cervical carcinogenesis.With the deepening of cervical lesions,the serum folic acid and erythrocyte folic acid level in women decreased more.Objective:To study the expression of human serum folic acid and erythrocyte folic acid in different grades of cervical squamous intraepithelial lesions.To explore the possible role of serum folic acid and erythrocyte folic acid in the process of cervical carcinogenesis,to explore the potential early warning factors for cervical intraepithelial neoplasia and the interaction of hidden risk factors for cervical intraepithelial neoplasia,add broader ideas for the prevention and health care of cervical cancer.Methods:352 female patients who were selected from January 2016 to December 2018 in Guangxi Tumor Hospital,those who were diagnosed with SIL were diagnosed by thinprep cytologic test or biopsy.There were 150 cases of low cervical squamous intraepithelial lesion and 202 cases of high cervical squamous intraepithelial lesion.The subjects were divided into LSIL group(n=150)and HSIL group(n=202).Meanwhile,there were 150 patients who were diagnosed as inflammatory changes or normal by thinprep cytologic test or biopsy were selected as the control group(n=150).To investigate the related data of all subjects,such as medical characteristics,recent medication history and so on.And to collect the venous blood of all subjects under fasting condition,use the Beckman Coulter Access to detect the level of serum folate and erythrocyte folic acid level by chemiluminescence.Then use SPSS25.0 analysis software to analyze all the data.Results:1.There were no significant differences in birthplace,smoking,passive smoking,tea drinking,among control group,LSIL group and HSIL group.There were significant differences in age(P=0.005<0.05),nation(P=0.O1<0.05),drinking(P=0.03<0.05).2.There was significant difference in overall distribution from age(H=16.948,P=0.000<0.05),erythrocyte folic acid level(H=10.496,P=0.005<0.05),but there was no significant difference in overall distribution from Serum folic acid(H=162.28,P=0.564>0.05).3.The levels of erythrocyte folic acid in control group,LSIL group and HSIL group were 7.39±4.17nmol/L,6.60±3.26nmol/L and 6.45±4.01 nmol/L(median ±quartile interval).With the aggravation of the lesion,the level of erythrocyte folic acid(median±quartile interval)decreased.There was no statistical difference between control group and LSIL group(adjusted P=0.107),There was no statistical difference between LSIL group and HSIL group(adjusted P=1.000).The concentration of serum folic acid in HSIL group was lower than that in control group(P<0.05).The concentration of erythrocyte folic acid in HSIL group was lower than that in control group.4.Comparison of serum folic acid and erythrocyte folic acid levels among control group,LSIL group and HSIL group under different ages,different nationalities and different drinking conditions,The results showed that the levels of serum folic acid and erythrocyte folic acid in control group,LSIL group and HSIL group had no statistical significance among different ages,different nationalities and different drinking conditions.5.In the regression analysis of SIL occurrence,erythrocyte folic acid(OR=0.915,P=0.030)was included in the model with statistical significance,and erythrocyte folic acid was an independent risk factor for the occurrence of cervical intraepithelial lesions,and the risk of erythrocyte folic acid decreased by 1 nmol in SIL progression regression analysis increased by 0.915 times,but there was no significant difference in the regression analysis of SIL progression.Conclusion:1.There was no difference in serum folic acid levels among normal subjects,LSIL patients and HSIL patients.2.There were differences in erythrocyte folic acid levels among normal human body,LSIL patients and HSIL patients,and with the aggravation of SIL,the erythrocyte folic acid expression level(median ±quartile interval)tended to decrease,and the difference was more obvious between normal subjects and HSIL patients.3.According to the analysis of logistic regression model,low erythrocyte folic acid level is the risk factor of cervical squamous intraepithelial lesion,and red folic acid can be used as a valuable clinical index of SIL.