Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women.

Autor:	Shih YW; School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.; Post‑Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan., Chang CW; Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan., Chang HR; School of Nursing and Midwifery, Western Sydney University, Australia., Tsai JR; Department of Medical Oncology, Taipei Medical University Taipei Cancer Center/Taipei Medical University Hospital, Taipei, Taiwan., Wang WJ; Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan.; Proton Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan., Fang HF; Department of Nursing, Taipei Medical University Taipei Cancer Center/Taipei Medical University Hospital, Taipei, Taiwan., Lin CL; Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan., Rias YA; Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand.; Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Indonesia., Tsai HT; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.; Post‑Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	Biological research for nursing [Biol Res Nurs] 2024 Jul; Vol. 26 (3), pp. 380-389. Date of Electronic Publication: 2024 Jan 25.
DOI:	10.1177/10998004241229069
Abstrakt:	Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case-control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01-0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01-0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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