| Abstract: | 正常的子宮頸上皮細胞變化為子宮頸癌之前，會經過一連串的細胞分化。已知第二型糖尿病與子宮頸癌的發生率和死亡率的增加有關；然而，高血糖是否相關於子宮頸上皮細胞之病變則是不清楚的。本研究是一項以醫院為基礎的回溯性世代研究，分析3,937名研究對象從2011年1月1日至2017年12月31日之子宮頸抹片與切片檢查資料。研究對象於研究期間至少進行兩次的子宮頸抹片檢查；其中，第一次抹片檢查異常率為12.9%，第二次抹片檢查異常率則增加至16.2%。第一次抹片檢查異常者經切片檢查判定為分化不良之上皮內病變一期 (cervical intraepithelial neoplasia-1, CIN1)、CIN2、以及CIN3之比率分別為41.1%、11.6%、以及2.9%，第二次抹片檢查異常者經切片檢查判定為CIN1、CIN2、以及CIN3之比率分別增加為46.7%、21.8%、以及4.9%。進一步地，在調整干擾因子之效應後，相較於空腹血糖正常者，空腹血糖為100-125 mg/dL者 (odds ratio [OR] = 1.47，95% confidence interval [C.I.] = 1.00-2.16) 與
Normal cervical epithelial cells undergo a series of cell differentiation before they change to cervical cancer. Type 2 diabetes is known to be associated with an increased incidence of cervical cancer and mortality; however, it is unclear whether hyperglycemia is associated with lesions of cervical epithelial cells. This study was a hospital-based retrospective generation study that analyzed 3,937 subjects with Pap smear and biopsy data from January 1, 2011 to December 31, 2017. During the study period, all subjects underwent at least two Pap smear tests; abnormality rate in the first smear test was 12.9%, and abnormality rate in the second smear test increased to 16.2%. The proportions in subjects with abnormalities in the first smear examination that were further determined by the biopsy to be cervical intraepithelial neoplasia-1 (CIN1), CIN2, and CIN3 were 41.1%, 11.6%, and 2.9%, respectively. The proportions in subjects with abnormalities in the second smear examination that were further determined by the biopsy to be CIN1, CIN2, and CIN3 increased to 46.7%, 21.8%, and 4.9%, respectively. Moreover, after adjusting for the effects of confounding factors, compared to the subjects with normal fasting blood glucose, those with fasting blood glucose 100-125 mg/dL (odds ratio [OR] = 1.47, 95% confidence interval [C.I.] = 1.00-2.16) and >= 126 mg/dL showed a significantly higher risk in the deterioration of epithelial cell (OR = 1.85, 95% C.I. = 0.99-3.45), respectively. Therefore, blood glucose may be an important factor affecting the development of cervical precancerous lesions. |
