在美国队列研究中，通过机器学习利用血液金属水平预测消化道癌症风险。

Blood metal levels predict digestive tract cancer risk using machine learning in a U.S. cohort.

作者信息

Shi Chenyuan, Jiang Hanfeng, Zhao Fangzhou, Zhang Yigang, Chen Haoming

机构信息

Department of Emergency Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.

School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China.

出版信息

Sci Rep. 2025 Jan 8;15(1):1285. doi: 10.1038/s41598-025-85659-y.

DOI:10.1038/s41598-025-85659-y

PMID:39779803

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11711503/

Abstract

BACKGROUND

Environmental metal exposure has been implicated in the development of digestive tract cancers, although the specific associations remain poorly defined. This study aimed to investigate the relationship between blood metal levels and the risk of digestive tract cancers among U.S. adults.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, including 13,467 participants aged 20 years and older, were analyzed. Nine blood metals were measured. Multivariable logistic regression, restricted cubic spline models, and subgroup analyses were employed to assess the associations between metal levels and cancer risk. Additionally, a Random Forest (RF) model was used for cancer risk prediction.

RESULTS

Among the participants, 9 had esophagus cancer (EC), 11 had gastric cancer (GC), and 83 had colorectal cancer (CRC). Compared to healthy controls, EC patients exhibited significantly higher blood levels of potassium (K, 4.40 vs. 4.00 mmol/L), cadmium (Cd, 12.46 vs. 2.49 µg/L), and lead (Pb, 0.09 vs. 0.05 µg/L). GC patients had elevated Pb levels (0.08 vs. 0.05 µg/L), while CRC patients showed higher concentrations of Cd (3.11 vs. 2.49 µg/L) and Pb (0.06 vs. 0.04 µg/L). Logistic regression analysis revealed significant associations between higher K (odds ratio [OR] = 7.58, 95% CI: 3.48-16.48, P < 0.0001), Cd (OR = 1.06, 95% CI: 1.04-1.08, P < 0.0001), and Pb (OR = 7.60, 95% CI: 3.26-17.72, P < 0.0001) levels and EC risk. Pb was also significantly associated with GC (OR = 5.26, 95% CI: 2.11-13.10, P < 0.001). The RF model showed an accuracy of 76% in predicting cancer risk, with SHapley Additive exPlanations (SHAP) analysis highlighting Cd and iron (Fe) as key contributors.

CONCLUSIONS

The study reveals a positive association between certain blood metals and digestive tract cancer risk, suggesting that limiting exposure to these metals may serve as a potential preventive measure.

摘要

背景

环境金属暴露与消化道癌症的发生有关，尽管具体关联仍不明确。本研究旨在调查美国成年人血液金属水平与消化道癌症风险之间的关系。

方法

分析了2011 - 2018年美国国家健康与营养检查调查（NHANES）的数据，包括13467名20岁及以上的参与者。测量了九种血液金属。采用多变量逻辑回归、受限立方样条模型和亚组分析来评估金属水平与癌症风险之间的关联。此外，使用随机森林（RF）模型进行癌症风险预测。

结果

在参与者中，9人患有食管癌（EC），11人患有胃癌（GC），83人患有结直肠癌（CRC）。与健康对照组相比，食管癌患者的血钾（K，4.40对4.00 mmol/L）、血镉（Cd，12.46对2.49 μg/L）和血铅（Pb，0.09对0.05 μg/L）水平显著更高。胃癌患者的血铅水平升高（0.08对0.05 μg/L），而结直肠癌患者的血镉（3.11对2.49 μg/L）和血铅（0.06对0.04 μg/L）浓度更高。逻辑回归分析显示，血钾升高（优势比[OR]=7.58，95%置信区间：3.48 - 16.48，P<0.0001）、血镉（OR=1.06，95%置信区间：1.04 - 1.08，P<0.0001）和血铅（OR=7.60，95%置信区间：3.26 - 17.72，P<0.0001）水平与食管癌风险之间存在显著关联。血铅也与胃癌显著相关（OR=5.26，95%置信区间：2.11 - 13.10，P<0.001）。RF模型在预测癌症风险方面的准确率为76%，SHapley加性解释（SHAP）分析突出了镉和铁（Fe）是关键因素。