Department of General Surgery, Department of Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology, China; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 511443, China.
Environ Res. 2024 Jan 1;240(Pt 1):117529. doi: 10.1016/j.envres.2023.117529. Epub 2023 Oct 26.
Colorectal cancer (CRC) is widely known with a high incidence rate worldwide, but the correlation between exposure to per- and polyfluoroalkyl substances (PFAS) and the number of lymph nodes in CRC patients remains unclear. In the present study, we enrolled 305 CRC patients (122 females and 183 males) at Beijing Hospital in China. A total of 17 PFAS were detected in serum samples of these patients, and 5 PFAS with detection rates >75% were selected in this study. The CRC patients' number of metastatic lymph nodes (MLNs) and total lymph nodes (TLNs) were chosen as outcomes. Poisson regression models were used to analyze the associations between single PFAS and number of MLNs and TLNs. Quantile g-Computation models were performed to examine the joint effect of PFAS mixtures on number of MLNs and TLNs. A positive correlation between serum PFAS levels and number of MLNs was identified. For instance, the numbers of MLNs in patients with serum PFOA, PFNA, 6:2 Cl-PFESA concentrations at the 95th percentile were 27% (95% CI: 1%, 60%), 35% (95% CI: 1%, 82%), 87% (95% CI: 4%, 238%) higher compared with the threshold level. The results of Quantile g-Computation models also showed that every quantile increase in PFAS mixtures was associated with a 4.67%, (95% CI: 0.07%, 9.48%) increase in the numbers of MLNs, and PFOS dominated the effects of the mixtures. Moreover, a negative correlation between PFAS mixtures and number of TLNs in patients with no MLNs was also observed. The present study suggested that exposure to PFAS may worsen the prognosis of CRC patients. These findings could help guide future research and public health policies aimed at reducing exposure to PFAS and mitigating their potential impacts on human health.
结直肠癌（CRC）在全球范围内发病率较高，是一种广为人知的疾病，但接触全氟和多氟烷基物质（PFAS）与 CRC 患者的淋巴结数量之间的相关性尚不清楚。本研究纳入了中国北京医院的 305 名 CRC 患者（女性 122 名，男性 183 名）。检测了这些患者血清样本中的 17 种 PFAS，选择了 5 种检出率>75%的 PFAS 进行本研究。将 CRC 患者的转移淋巴结（MLNs）和总淋巴结（TLNs）数量作为结果。使用泊松回归模型分析了单个 PFAS 与 MLNs 和 TLNs 数量之间的关系。进行了分位数 g 计算模型以检验 PFAS 混合物对 MLNs 和 TLNs 数量的联合作用。结果表明，血清 PFAS 水平与 MLNs 数量呈正相关。例如，血清 PFOA、PFNA、6:2 Cl-PFESA 浓度处于第 95 百分位数的患者的 MLNs 数量比阈值水平高 27%（95%CI：1%，60%）、35%（95%CI：1%，82%）、87%（95%CI：4%，238%）。分位数 g 计算模型的结果还表明，PFAS 混合物每增加一个分位数，MLNs 数量就会增加 4.67%（95%CI：0.07%，9.48%），而 PFOS 则主导着混合物的作用。此外，在无 MLNs 的患者中，PFAS 混合物与 TLNs 数量之间还存在负相关。本研究表明，接触 PFAS 可能会使 CRC 患者的预后恶化。这些发现有助于指导未来的研究和公共卫生政策，旨在减少接触 PFAS 并减轻其对人类健康的潜在影响。
