Expression And Significance Of Serum Vitamin D In Cervical Cancer

Objective:Cervical cancer is a common malignant tumor of the female reproductive system with high morbidity and mortality.The occurrence of cervical cancer is a multi-stage and multi-step complex process.In addition to persistent infection with HR-HPV,abnormal immune function is also an important mechanism leading to the occurrence of cervical cancer.It is now believed that T lymphocytes can reflect the immune function of the body and the degree of disease development.In addition,vitamin D(VD)as a common nutrient,its deficiency is closely related to the occurrence and development of cancer,and VD plays various biological roles in regulating the immune system in vivo by binding to the vitamin D receptor(VDR),etc.VDR activity is affected by single nucleotide polymorphism(SNP),and FOKI is the only known VDR SNP that changes the length of amino acid sequence.FOKI is the only known VDR SNP that alters the amino acid sequence length.In this study,we investigated the relationship between these indicators and cervical cancer by measuring the expression levels of serum VD,CD4 and CD8 and FOKI genotype detection in different populations,aiming to provide a possibility to study the mechanism of cervical cancer.Methods:Among patients who underwent biopsy at the colposcopy clinic of the Department of Obstetrics and Gynecology,Second Hospital of Shanxi Medical University for HR-HPV infection and/or abnormal TCT results from September 1,2020 to October 1,2021,patients who visited the clinic with positive HPV16 were studied,and pathological findings were used as the basis for grouping,and those with pathological findings showing chronic inflammation and CIN1 were classified as the control group,and those with CIN2+ were classified as the case group.On this basis,CIN2 and CIN3 were divided into the HISL group and squamous carcinoma into the SCC group.Informed consent forms were signed,questionnaires were completed and fasting blood samples were taken.After screening according to the inclusion and exclusion criteria,a total of431 people were enrolled,including 210 in the case group and 221 in the control group.Random sampling was performed using SPSS 26.0,and 188 cases each in the case and control groups were finally included.148 people were finally included in the HSIL group and 40 people in the SCC group.Serum CD4 and CD8 levels were detected by enzyme immunoassay,and FOKI genotype was detected by Taq Man fluorescent probe.In addition,all factors affecting cervical lesions except those affecting VD were subjected to propensity score matching analysis using 1:1 nearest neighbor matching with a matching tolerance of 0.01,and the SCC and HSIL groups were matched with the control group respectively,and finally 121 cases each in the HSIL group and the control group were matched successfully,and 31 cases each in the SCC group and the control group were matched successfully,and the results before and after matching were compared The results before and after matching were compared.A X2-test was used for comparison between groups for count data,a t-test or a non-parametric test was used for comparison between groups for measurement data,and a X2-test was used to determine whether the genotype of the control population followed the Hardy-Weinberg equilibrium law.Spearman’s correlation coefficient was applied to analyze the correlation between VD and CD4 and CD8,and a logistics regression to analyze the high-risk factors for cervical cancer,and p<0.05 was considered a statistically significant difference.Results:1.After propensity score matching,the differences in VD deficiency rate,CD4 reduction rate and CD8 elevation rate were statistically significant in the SCC and HSIL groups compared with the control group(P<0.001),which were consistent with the results of pre-match analysis.2.After propensity score matching,the VD deficiency rate was 18.18%(22/121)in the HSIL group and 48.39%(15/31)in the SCC group,and the difference was statistically significant(P<0.001)in the VD deficiency group compared with the adequate group,which was consistent with the results of the pre-match analysis.3.Serum 25-(OH)-D3 and CD4 were negatively correlated with the degree of lesions(correlation coefficients r=0.527 and r=0.475,respectively,P<0.001),i.e.,the more severe the cervical lesions,the lower the serum 25-(OH)-D3 and CD4 levels;CD8was positively correlated with the degree of lesions(r=-0.574,P<0.001),i.e.,the more severe the cervical lesions,the more severe the cervical lesion,the higher the serum CD8 level,and the difference was statistically significant.4.After propensity score matching,serum 25-(OH)-D3 showed a moderate positive correlation with CD4 levels,with a statistically significant difference(r=0.470,P<0.001),and serum 25-(OH)-D3 showed a moderate negative correlation with CD8 levels,with a statistically significant difference(r=-0.436,P<0.001),consistent with the results of pre-match analysis.5.After propensity score matching,serum VD deficiency was a risk factor for cervical carcinogenesis(OR=6.597,95%CI=2.095-20.778,P=0.001),and the difference was statistically significant and consistent with the results of pre-match analysis.6.After propensity score matching,FOKI ff genotype with f allele was associated with risk of SCC occurrence(ff vs FF: OR=4.821;95% CI=1.097-21.192;P=0.037;f vs F: OR=2.390;95% CI=1.152-4.957;P=0.019),the difference was statistically significant and inconsistent with pre-match analysis.Conclusion:1.Serum vitamin D deficiency and abnormal expression of CD4 and CD8 exist in patients with cervical cancer.2.Serum vitamin D deficiency is associated with abnormal expression of CD4 and CD8,suggesting that vitamin D deficiency is related to abnormal immune function of the body3.Serum vitamin D deficiency,FOKI ff genotype and f allele are risk factors for the occurrence of cervical cancer.