Neamtiu Iulia A, Bloom Michael S, Dumitrascu Irina, Roba Carmen A, Pop Cristian, Ordeanu Claudia, Balacescu Ovidiu, Gurzau Eugen S
Health Department, Environmental Health Center, Cluj-Napoca, Romania; IMOGEN Research Institut, Cluj-Napoca, Romania.
Health Department, Environmental Health Center, Cluj-Napoca, Romania; Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, United States of America.
PeerJ. 2016 Sep 8;4:e2448. doi: 10.7717/peerj.2448. eCollection 2016.
Cancer research is a national and international priority, with the efficiency and effectiveness of current anti-tumor therapies being one of the major challenges with which physicians are faced.
To assess the impact of exposure to tobacco smoke, arsenic, and phthalates on cervical cancer treatment.
We investigated 37 patients with locally advanced cervical carcinoma who underwent chemotherapy and radiotherapy. We determined cotinine and five phthalate metabolites in urine samples collected prior to cancer treatment, by gas chromatography coupled to mass spectrometry, and urinary total arsenic by atomic absorption spectrometry with hydride generation. We used linear regression to evaluate the effects of cotinine, arsenic, and phthalates on the change in tumor size after treatment, adjusted for confounding variables.
We detected no significant associations between urinary cotinine, arsenic, or phthalate monoesters on change in tumor size after treatment, adjusted for urine creatinine, age, baseline tumor size, and cotinine (for arsenic and phthalates). However, higher %mono-ethylhexyl phthalate (%MEHP), a putative indicator of phthalate diester metabolism, was associated with a larger change in tumor size (β = 0.015, 95% CI [0.003-0.03], P = 0.019).
We found no statistically significant association between the urinary levels of arsenic, cotinine, and phthalates metabolites and the response to cervical cancer treatment as measured by the change in tumor size. Still, our results suggested that phthalates metabolism may be associated with response to treatment for locally advanced cervical cancer. However, these observations are preliminary and will require confirmation in a larger, more definitive investigation.
癌症研究是一项国内和国际重点工作，当前抗肿瘤治疗的效率和效果是医生面临的主要挑战之一。
评估接触烟草烟雾、砷和邻苯二甲酸盐对宫颈癌治疗的影响。
我们调查了37例接受化疗和放疗的局部晚期宫颈癌患者。通过气相色谱-质谱联用技术测定癌症治疗前采集的尿液样本中的可替宁和五种邻苯二甲酸盐代谢物，并通过氢化物发生原子吸收光谱法测定尿总砷。我们使用线性回归来评估可替宁、砷和邻苯二甲酸盐对治疗后肿瘤大小变化的影响，并对混杂变量进行了校正。
在校正尿肌酐、年龄、基线肿瘤大小和可替宁（针对砷和邻苯二甲酸盐）后，我们未发现尿可替宁、砷或邻苯二甲酸单酯与治疗后肿瘤大小变化之间存在显著关联。然而，较高的邻苯二甲酸单（2-乙基己基）酯（%MEHP），一种邻苯二甲酸二酯代谢的假定指标，与肿瘤大小的较大变化相关（β = 0.015，95%CI[0.003 - 0.03]，P = 0.019）。
我们发现尿液中砷、可替宁和邻苯二甲酸盐代谢物水平与以肿瘤大小变化衡量的宫颈癌治疗反应之间无统计学显著关联。尽管如此，我们的结果表明邻苯二甲酸盐代谢可能与局部晚期宫颈癌的治疗反应相关。然而，这些观察结果是初步的，需要在更大规模、更具确定性的研究中得到证实。
