Muñoz-Bravo Carlos, Marín-Burdallo Inés, González-Herrera Lucas, González-Palacios Torres Carla, Lozano-Lorca Macarena, Jiménez-Moleón José Juan, Olmedo-Requena Rocío
Department of Public Health and Psychiatry, School of Medicine, University of Málaga, 29071 Málaga, Spain.
Biomedical Research Institute of Malaga (IBIMA), 29010 Málaga, Spain.
Carcinogenesis. 2025 Jan 20;46(1). doi: 10.1093/carcin/bgaf001.
Several clinical studies have evaluated the relationship between copper on colorectal cancer (CRC), but the results are contradictory. This study aimed to conduct a systematic review and meta-analysis to investigate copper measured in two biological matrices (serum/plasma/blood and tissue) and dietary intake in CRC patients compared to healthy controls. We conducted a comprehensive and systematic search in PubMed, Scopus, Embase, and Web of Science. We included studies that reported copper levels in serum/plasma/blood, tissue, or from the diet, with an observational study design (cohort and case-control studies). Study quality was assessed with the Newcastle-Ottawa scale and potential causes of heterogeneity were evaluated. Standardized mean differences (SMD) with 95% confidence interval (CI) were pooled using random-effect models. Overall pooled odds ratio and 95% CI for the risk of CRC were calculated. Twenty-six studies (23 case-control and 3 cohort studies) with a total of 227 354 participants were included. Most of the studies presented low (50%) or moderate quality (42.3%). No differences in serum/plasma/blood copper levels (SMD = 0.23; 95% CI: -0.23, 0.70; I2 = 97.3%, 19 studies), tissue copper levels (SMD = -1.69; 95% CI: -3.41, 0.03; I2 = 85.6%, 2 studies), or copper/zinc ratio (SMD = 1.19; 95% CI: 0.54, 1.84; I2 = 95.3%, 6 studies) were found between CRC patients and healthy controls. Regarding dietary copper, CRC patients had a lower intake (SMD = -0.27; 95% CI: -0.51, -0.03; I2 = 0.0%, 2 studies). No differences were found in copper levels between CRC patients and healthy controls. However, evidence shows mostly low or moderate quality, and results were heterogeneous. More prospective studies with an adequate methodological approach are needed.
多项临床研究评估了铜与结直肠癌（CRC）之间的关系，但结果相互矛盾。本研究旨在进行系统评价和荟萃分析，以调查与健康对照相比，结直肠癌患者在两种生物基质（血清/血浆/血液和组织）中测得的铜含量以及饮食摄入量。我们在PubMed、Scopus、Embase和Web of Science中进行了全面系统的检索。我们纳入了采用观察性研究设计（队列研究和病例对照研究）报告血清/血浆/血液、组织或饮食中铜水平的研究。使用纽卡斯尔-渥太华量表评估研究质量，并评估异质性的潜在原因。采用随机效应模型汇总标准化均数差（SMD）及95%置信区间（CI）。计算CRC风险的总体合并比值比及95%CI。纳入了26项研究（23项病例对照研究和3项队列研究），共227354名参与者。大多数研究质量较低（50%）或中等（42.3%）。在结直肠癌患者和健康对照之间，未发现血清/血浆/血液铜水平（SMD = 0.23；95%CI：-0.23，0.70；I2 = 97.3%，19项研究）、组织铜水平（SMD = -1.69；95%CI：-3.41，0.03；I2 = 85.6%，2项研究）或铜/锌比值（SMD = 1.19；95%CI：0.54，1.84；I2 = 95.3%，6项研究）存在差异。关于饮食中的铜，结直肠癌患者的摄入量较低（SMD = -0.27；95%CI：-0.51，-0.03；I2 = 0.0%，2项研究）。在结直肠癌患者和健康对照之间未发现铜水平存在差异。然而，证据大多显示质量较低或中等，且结果存在异质性。需要更多采用适当方法学的前瞻性研究。
