Can B12 and Folate Levels Predict HPV Penetration in Patients With ASCUS?
Can B12 and Folate Levels Predict HPV Penetration in Patients With ASCUS?
Non-classified atypical squamous cells (ASCUS) is the most common abnormal cervical cytology
 (%39). The risk of cervical intraepithelial neoplasia 2-3 is 5% and the risk of carcinoma is
 around 0.1% after diagnosis. Mostly human papillomavirus (HPV) is responsible for this
 transition. Most of them are transient, but some infections become persistent and can
 progress into precancer and invasive cancer. In the process of progression to cancer;
 patients with cell cycle problems are thought to be at risk. In some studies, B12 and folate
 deficiency, which play a role in DNA synthesis and repair, have been shown to induce
 incorrect binding of uracil to DNA, leading to DNA breakage and repair disorder. Therefore,
 in this study, it has been aimed that the relation of presence of atypical squamous cells and
 HPV persistence with folate and vitamin B12 levels which effect on immune system.
Participants were divided into two groups according to their smear results; atypical squamous
 cells of undetermined significance (ASCUS) (study group: 100 patients) and women who did not
 have intraepithelial neoplasia as a result of smear (control group: 100 patients). Patients
 who had well preserved sufficient number of squamous epithelial cells, who did not have
 bleeding, fixation failure, inflammation or atrophy, and had negative cervical cytology smear
 were considered as control group. HPV test was also requested from the study group. B12 and
 folate blood levels were compared between the groups.
Inclusion Criteria:

 -  female patients aged between 30-65 who were undergoing smear tests with the aim of
 control

 -  body mass index (BMI) lower than 35

 -  Participants did not have any chronic diseases

 Exclusion Criteria:

 -  Patients taking B12 and folate supplement due to mix type anemia

 -  patients taking active vitamin B12 and folate-containing vitamin supplements

 -  pregnant women

 -  women with other cervical intraepithelial lesions such as low grade squamous
 intraepithelial lesion (LGSIL), high grade squamous intraepithelial lesion (HGSIL) or
 high grade squamous intraepithelial lesion can not be excluded (ASC-H) in smear

 -  patients with cervical cancer diagnosis

 -  patients who were operated due to cervical cancer

 -  patients who had HPV vaccine

 -  patients with a diagnosis that can inhibit B12 and folate absorption in
 gastro-intestinal tract

 -  vegetarians