Relationship Between HPV Infection And High Cervical Lesions (CINⅡ~+) And Behavior Factors, Trace Elements And Vitamins In Uyghu Women In Bachu County, Xinjiang

Objective:To study the relationship between HPV infection and high cervical lesions and behavior,trace elements and vitamins in Uyghur women in Bachu, Xinjiang, the diagnostic value of trace elements and vitamins applied in predicting HPV infection and high cervical lesions,and the correlation between trace elements in soil and drinking water and the incidence of HPV infection and high cervical lesions including cervical cancer in order to provide the basis for intervention of cervical cancer.Methods:1. Six hundred and forty-six objects with ≥ASC-US or care HPV positive or VIA/VILI positive were enrolled through screening 5045 Uyghur women in Bachu,Xinjiang from March 1, 2014 to June 15, 2014. In addition, 187 objects with cervical disease from Bachu were enrolled in the department of gynecology in the Affiliated Tumor Hospital of Xinjiang Medical University. All participants underwent biopsy under colposcope for histopathologic examination. The participants with ≥ CINⅡ were regarded as case group, and < CINⅡ as control group. The participants with HPV infection were regarded as HPV positive group, and without HPV infection as HPV negative group. All participants underwent epidemiological investigation, and the concentrations of trace elements and vitamins in serum were detected.2.The samples of soil and drinking water were collected in nine towns including Bachu, Awati, Selibuya, Qiongkuqiake, Alageer, Akesake, Qiaerbage, Anarekuli and Duolaitibage in Bachu, Xinjiang. The concentration of trace elements of As, Cd, Co, Ni,Cu, Zn, Mn, Se and Fe were determined by atomic absorption spectrophotometry and inductively coupled plasma atomic emission spectroscopy, respectively.3. Univariate analysis was performed with chi-square test between HPV positive group and negative group, and between case group and control group, multivariate analysis were performed with Logistic regression, diagnostic value of trace elements and vitamins in predicting HPV infection and high cervical lesions including cervical cancer were analyzed with diagnostic test and receiver operating characteristic curve, and correlation between the concentrations of trace elements in soil and drinking water and the incidence of HPV infection and high cervical lesions including cervical cancer was performed with partial correlation analysis.Results:1.Behavior risk factors of HPV infection for Uyghur women in Bachu included age of marriage ≤ 15 years old, marriage times ≥3, sexual frequency ≥3/ week, bathing frequency,delivery at home, using toilet paper during menstrual period, using soil block in toilet, bad personal care, no birth control and spouse′ smoking, and behavior risk factors of high cervical lesions including cervical cancer for Uyghur women in Bachu included family income <10000 RMB, marriage times ≥3, delivery at home, a history of cervical cancer,bad personal care, using toilet paper during menstrual period and spouse′ smoking.2.The concentration of As ≥0.02 mg/Kg and VD3≥49.6434ng/L were risk factors for HPV infection, and the concentration of Ni ≥0.1232 mg/Kg, Se ≥ 0.02 mg/Kg and FA≥17.6705 ug/L were protective factors. The concentration of Fe ≥ 6.9153 mmol/L and As≥0.02 mg/Kg were risk factors for high cervical lesions including cervical cancer, and the concentration of Ni ≥0.0965 mg/Kg, Se≥0.02 mg/Kg and VC≥0.6857ug/L were protective factors.3. The diagnostic value of As, Ni, Se, VD3 and FA applied in predicting HPV infection were low, and the area under ROC curve was lower than 0.700.4.Se, Se combined with As, and Se combined with Ni could be applied in predicting high cervical lesions including cervical cancer, and their area under ROC curve was higher than 0.700. The sensitivity and negative predictive value were high, and false negative rate was lower; but the specificity, accuracy and positive predictive value were lower, and false positive rate was high.5.The concentration of trace elements(As、Cd、Co、Ni、Cu、Mn、Se、Fe and Zn) was in normal scope in Bachu. The concentration of As and Cu was positively correlated with the incidence of high cervical lesions including cervical cancer in soil, and Se was negatively correlated with the incidence of high lesions. The concentration of As was positively correlated with the incidence of high cervical lesions in drinking water, and Zn was negatively correlated with the incidence of high cervical lesions; the concentration of As was positively correlated with the rate of HPV infection in soil, and Se was negatively correlated with the rate of HPV infection. The concentration of Cu was positively with the rate of HPV infection in drinking water, and Se was negatively correlated with the rate of HPV infection.Conclusions:Behavior risk factors had an important role in HPV infection and cervical lesions for Uyghur women in Bachu, and preventive measures should be taken to reduce the incidence of HPV infection and cervical lesions; trace elements and vitamins were correlated with HPV infection and cervical lesions, and preventive measures should be taken to improve the status of trace elements and vitamins; Se, Se combined with As, and Se combined with Ni could be applied in the preliminary screening of high cervical lesions including cervical cancer; trace elements in soil and drinking water were correlated with the incidence of HPV infection and the development of cervical lesions and cervical cancer in Bachu, Xinjiang.