Department of Toxicology, Faculty of Pharmacy, Medical University of Lodz, Łódź, Poland.
Int J Occup Med Environ Health. 2013 Apr;26(2):291-301. doi: 10.2478/s13382-013-0089-z. Epub 2013 May 20.
Cadmium (Cd) is a persistent and widespread environmental pollutant, which may constitute a potential risk factor for hormone-dependent tumors such as endometrial cancer. The vascular endothelium is an important target of cadmium toxicity, which may interfere with the coagulation cascade and fibrinolytic system. The aim of this research was to investigate whether in female patients with uterine endometrial cancer or myoma in comparison to healthy women, the concentration of cadmium in blood affects the process of coagulation and fibrinolysis.
The study group comprised 91 women: 35 healthy (A-control), 39 with uterine myoma (B) and 17 with endometrial cancer (C), in which blood cadmium concentrations (BCd), coagulation and selected fibrinolysis parameters in plasma were assayed.
In the women with myoma and especially in those with endometrial cancer disturbances in coagulation and fibrinolysis were detected when compared to the healthy women. In the group of women with endometrial cancer significant changes in prothrombin index, levels of fibrinogen, fibrin D-dimer and t-PA were observed. Whereas, in the patients with myoma significant changes in prothrombin time, index of vWillebrand Factor and fibrin D-dimer level were noted. Mean BCd concentrations in subsequent groups were as follows: B - 0.91±0.81; C - 0.78±0.45 μg Cd/l and did not differ significantly in comparison with the control group (0.86±0.35 μg Cd/l). However, in each study group smokers had approximately twice as high BCd as non-smokers. Studies also showed significant associations between BCd and fibrinogen level and thrombin time among the women with myoma and endometrial cancer, as well as in healthy women. Moreover, thrombin time significantly correlated with fibrinogen level in the women studied.
In the patients with myoma and especially in these with endometrial cancer disturbances in coagulation and fibrinolysis parameters leading to hypercoagulability were detected. Exposure to cadmium can be one of the factors inducing these changes.
镉（Cd）是一种持久且广泛存在的环境污染物，可能构成激素依赖性肿瘤（如子宫内膜癌）的潜在危险因素。血管内皮是镉毒性的重要靶标，可能会干扰凝血级联和纤维蛋白溶解系统。本研究旨在探讨女性子宫内膜癌或子宫肌瘤患者与健康女性相比，血液中镉浓度是否会影响凝血和纤溶过程。
研究组包括 91 名女性：35 名健康女性（A-对照组）、39 名子宫肌瘤患者（B 组）和 17 名子宫内膜癌患者（C 组），检测了她们的血液镉浓度（BCd）、凝血和部分纤溶参数。
与健康女性相比，患有子宫肌瘤的女性，尤其是患有子宫内膜癌的女性，其凝血和纤溶功能出现紊乱。在子宫内膜癌组中，凝血酶原指数、纤维蛋白原水平、纤维蛋白 D-二聚体和组织型纤溶酶原激活物水平显著改变。而在子宫肌瘤患者中，凝血酶时间、血管性血友病因子指数和纤维蛋白 D-二聚体水平发生显著变化。随后各组的平均 BCd 浓度如下：B 组为 0.91±0.81μgCd/L；C 组为 0.78±0.45μgCd/L，与对照组（0.86±0.35μgCd/L）相比无显著差异。然而，在每个研究组中，吸烟者的 BCd 浓度几乎是非吸烟者的两倍。研究还表明，在患有子宫肌瘤和子宫内膜癌的女性以及健康女性中，BCd 与纤维蛋白原水平和凝血酶时间之间存在显著相关性。此外，在研究对象中，凝血酶时间与纤维蛋白原水平显著相关。
在患有子宫肌瘤的患者中，尤其是在患有子宫内膜癌的患者中，检测到凝血和纤溶参数的紊乱，导致血液高凝状态。镉暴露可能是引起这些变化的因素之一。
