Department of Nephrology, Nanjing Children's Hospital, Affiliated to Nanjing Medical University, 72 Guangzhou road, Nanjing, Jiangsu Province 210008, China.
Biol Trace Elem Res. 2013 Jun;153(1-3):5-10. doi: 10.1007/s12011-013-9682-z. Epub 2013 May 3.
It is well documented that oxidative stress is involved in the pathogenesis of bladder cancer. Zinc (Zn) and copper (Cu) are important components of antioxidants. However, the association between Zn or Cu levels and bladder cancer remains elusive. The present study was designed to investigate the alteration of serum and urinary levels of Zn or Cu in bladder cancer patients compared with controls by performing a systematic review. We searched the PubMed, Embase, and Cochrane databases from January 1990 to March 2013 to identify studies that met our predefined criteria. Six studies were included. Bladder cancer patients demonstrated significantly lower levels of serum Zn (three studies, random effects standard mean deviation (SMD): -1.072, 95 % CI: -1.489 to -0.656, P <0.0001), markedly higher levels of serum Cu (three studies, random effects SMD: 1.069, 95 % CI: 0.302 to 1.836, P = 0.006) and urinary Zn (three studies, random effects SMD: 2.114, 95 % CI: 0.328 to 3.899, P = 0.02) compared with controls. No obvious difference was observed in urinary Cu levels between bladder cancer patients and controls (two studies, random effects SMD: 0.153, 95 % CI: -0.244 to 0.55, P = 0.449). No evidence of publication bias was observed. In conclusion, the disorder of Zn and Cu is closely associated with bladder cancer. Frequent monitoring and early intervention should be recommended.
大量文献资料表明氧化应激与膀胱癌的发病机制有关。锌（Zn）和铜（Cu）是抗氧化剂的重要组成部分。然而，Zn 或 Cu 水平与膀胱癌之间的关联仍然难以确定。本研究旨在通过系统评价，调查膀胱癌患者与对照组相比血清和尿液中 Zn 或 Cu 水平的变化。我们检索了 1990 年 1 月至 2013 年 3 月的 PubMed、Embase 和 Cochrane 数据库，以确定符合我们预先设定标准的研究。共纳入 6 项研究。膀胱癌患者的血清 Zn 水平显著降低（3 项研究，随机效应标准均数差（SMD）：-1.072，95%CI：-1.489 至-0.656，P<0.0001），血清 Cu 水平显著升高（3 项研究，随机效应 SMD：1.069，95%CI：0.302 至 1.836，P=0.006），尿液 Zn 水平也显著升高（3 项研究，随机效应 SMD：2.114，95%CI：0.328 至 3.899，P=0.02），而对照组则没有明显差异。膀胱癌患者和对照组的尿 Cu 水平无明显差异（2 项研究，随机效应 SMD：0.153，95%CI：-0.244 至 0.55，P=0.449）。未发现发表偏倚的证据。总之，Zn 和 Cu 的紊乱与膀胱癌密切相关。建议进行频繁的监测和早期干预。
