Soleimani Yaser, Nayebi Mohammad, Mahmoudi Sheyda, Daraei Mahdi, Khorsand Soroush, Jahazi Mohammad Amin, Farsi Maryam Yadollahi, Khalafi Fatemeh, Varseh Mahdieh, Jarrahi Zahra Mousavi, Soleimani Mahna, Massoudnia Kamelia, Karamian Saeideh, Jarrahi Alireza Mosavi
Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Khomein University of Medical Sciences, Khomein, Iran.
PLoS One. 2025 Apr 29;20(4):e0319283. doi: 10.1371/journal.pone.0319283. eCollection 2025.
Pancreatic cancer is one of the most lethal malignancies, characterized by a poor prognosis and limited treatment options. Increasing evidence suggests that environmental factors, including heavy metal exposure, play a role in pancreatic cancer development. Cadmium, a toxic heavy metal classified as a Group 1 carcinogen, has been implicated in cancer progression. However, its association with pancreatic cancer remains uncertain, with conflicting results from epidemiological studies. This systematic review and meta-analysis aim to assess the association between cadmium exposure and the risk of pancreatic cancer.
A comprehensive literature search was conducted using multiple databases to identify studies that explored the relationship between cadmium exposure and pancreatic cancer risk. Eleven eligible studies were included in the meta-analysis. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated to estimate the overall effect size. Heterogeneity was assessed using I², T², and Cochran's Q-test. Publication bias was evaluated using Egger's and Begg's tests.
The pooled analysis revealed a significant association between cadmium exposure and the risk of pancreatic cancer, with an overall OR of 2.01 (95% CI: 1.30, 2.72), indicating that individuals exposed to cadmium had more than twice the risk of developing pancreatic cancer compared to those with lower or no exposure. Substantial heterogeneity was observed across studies (I² = 98.08%, T² = 1.37, H² = 52.21). Cochran's Q-test also indicated significant heterogeneity (Q(10) = 304.52, p = 0.00). Egger's test (p = 0.5040) and Begg's test (p = 1.0000) showed no evidence of publication bias.
This meta-analysis demonstrates a significant positive association between cadmium exposure and an increased risk of pancreatic cancer. Despite the considerable heterogeneity across studies, the findings suggest that cadmium is a potential environmental risk factor for pancreatic cancer. Further research is required to explore the underlying biological mechanisms and to develop strategies for reducing cadmium exposure, particularly in high-risk populations.
胰腺癌是最致命的恶性肿瘤之一,其特点是预后差且治疗选择有限。越来越多的证据表明,包括接触重金属在内的环境因素在胰腺癌的发生发展中起作用。镉是一种被归类为1类致癌物的有毒重金属,与癌症进展有关。然而,其与胰腺癌的关联仍不确定,流行病学研究结果相互矛盾。本系统评价和荟萃分析旨在评估镉暴露与胰腺癌风险之间的关联。
使用多个数据库进行全面的文献检索,以识别探讨镉暴露与胰腺癌风险之间关系的研究。荟萃分析纳入了11项符合条件的研究。计算合并比值比(OR)及其95%置信区间(CI),以估计总体效应大小。使用I²、T²和Cochran Q检验评估异质性。使用Egger检验和Begg检验评估发表偏倚。
汇总分析显示,镉暴露与胰腺癌风险之间存在显著关联,总体OR为2.01(95%CI:1.30,2.72),表明接触镉的个体患胰腺癌的风险是低暴露或无暴露个体的两倍多。各研究间观察到显著的异质性(I² = 98.08%,T² = 1.37,H² = 52.21)。Cochran Q检验也表明存在显著异质性(Q(10) = 304.52,p = 0.00)。Egger检验(p = 0.5040)和Begg检验(p = 1.0000)未显示发表偏倚的证据。
本荟萃分析表明,镉暴露与胰腺癌风险增加之间存在显著正相关。尽管各研究间存在相当大的异质性,但研究结果表明镉是胰腺癌的潜在环境风险因素。需要进一步研究以探索潜在的生物学机制,并制定减少镉暴露的策略,特别是在高危人群中。