Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), C/ Melchor Fernández Almagro 3, Madrid, Spain.
Gut. 2012 Nov;61(11):1583-8. doi: 10.1136/gutjnl-2011-301086. Epub 2011 Dec 19.
Knowledge on the aetiology of exocrine pancreatic cancer (EPC) is scant. The best established risk factor for EPC is tobacco smoking. Among other carcinogens, tobacco contains cadmium, a metal previously associated with an increased risk of EPC. This study evaluated the association between concentrations of trace elements in toenails and EPC risk.
The study included 118 EPC cases and 399 hospital controls from eastern Spain. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. OR and 95% CI, adjusted for potential confounders, were calculated using logistic regression.
Significantly increased risks of EPC were observed among subjects whose concentrations of cadmium (OR 3.58, 95% CI 1.86 to 6.88; p(trend)=5×10(-6)), arsenic (OR 2.02, 95% CI 1.08 to 3.78; p(trend)=0.009) and lead (OR 6.26, 95% CI 2.71 to 14.47; p(trend)=3×10(-5)) were in the highest quartile. High concentrations of selenium (OR 0.05, 95% CI 0.02 to 0.15; p(trend)=8×10(-11)) and nickel (OR 0.27, 95% CI 0.12 to 0.59; p(trend)=2×10(-4)) were inversely associated with the risk of EPC.
Novel associations are reported of lead, nickel and selenium toenail concentrations with pancreas cancer risk. Furthermore, the results confirm previous associations with cadmium and arsenic. These novel findings, if replicated in independent studies, would point to an important role of trace elements in pancreatic carcinogenesis.
外分泌胰腺腺癌（EPC）的病因学知识有限。EPC 最确定的危险因素是吸烟。在其他致癌物中，烟草含有镉，这种金属以前与 EPC 风险增加有关。本研究评估了脚趾甲中微量元素浓度与 EPC 风险之间的关联。
该研究包括来自西班牙东部的 118 例 EPC 病例和 399 例医院对照。通过电感耦合等离子体质谱法测定脚趾甲样本中 12 种微量元素的水平。使用逻辑回归计算调整了潜在混杂因素后的 OR 和 95%CI。
在镉（OR 3.58，95%CI 1.86 至 6.88；p（趋势）=5×10（-6））、砷（OR 2.02，95%CI 1.08 至 3.78；p（趋势）=0.009）和铅（OR 6.26，95%CI 2.71 至 14.47；p（趋势）=3×10（-5））浓度处于最高四分位数的受试者中，EPC 的发病风险显著增加。高浓度的硒（OR 0.05，95%CI 0.02 至 0.15；p（趋势）=8×10（-11））和镍（OR 0.27，95%CI 0.12 至 0.59；p（趋势）=2×10（-4））与 EPC 风险呈负相关。
报告了铅、镍和硒脚趾甲浓度与胰腺癌风险的新关联。此外，这些结果证实了以前与镉和砷的关联。如果在独立研究中得到复制，这些新发现将表明微量元素在外分泌胰腺致癌作用中的重要作用。
