Spyrakis Francesca, Tiburtini Gioele Antonio, Bruno Stefania, Dragani Tommaso A, Colombo Francesca
Department of Drug Science and Technology, University of Turin, Turin, Italy.
Department of Medical Sciences, University of Turin, Turin, Italy.
Front Oncol. 2025 Jul 30;15:1593300. doi: 10.3389/fonc.2025.1593300. eCollection 2025.
The potential link between perfluorooctanoic acid (PFOA) exposure and kidney cancer risk in humans remains uncertain. This meta-analysis aims to clarify the association by analyzing serum PFOA levels, a direct biomarker of internal exposure, rather than relying on indirect environmental or occupational measures.
A systematic literature search was conducted using PubMed and Web of Science to identify relevant studies. Random-effects models were applied to pool effect estimates for both continuous serum PFOA levels and categorical comparisons (highest vs. lowest exposure groups). Subgroup and sex-stratified analyses were also performed.
Three studies met the inclusion criteria, encompassing 1,011 kidney cancer cases and 2,251 controls. Analysis of continuous PFOA levels yielded a non-significant meta-relative risk (mRR) of 0.59 (95% CI: 0.06-5.89), with substantial heterogeneity. The highest versus lowest exposure comparison also showed no significant association (mRR: 0.98; 95% CI: 0.64-1.50). Sex-stratified results from two studies revealed no significant differences in risk.
The findings suggest that any increased kidney cancer risk related to serum PFOA exposure is likely small and not statistically significant based on current evidence. Despite biological plausibility for renal toxicity, epidemiological data remain inconclusive. Further research with larger populations and standardized exposure assessment is needed to determine PFOA's potential carcinogenic effects on the kidney.
全氟辛酸（PFOA）暴露与人类患肾癌风险之间的潜在联系仍不明确。本荟萃分析旨在通过分析血清PFOA水平（内部暴露的直接生物标志物）来阐明这种关联，而非依赖间接的环境或职业测量方法。
使用PubMed和Web of Science进行系统的文献检索，以识别相关研究。应用随机效应模型汇总连续血清PFOA水平和分类比较（最高暴露组与最低暴露组）的效应估计值。还进行了亚组分析和按性别分层的分析。
三项研究符合纳入标准，包括1011例肾癌病例和2251例对照。对连续PFOA水平的分析得出的荟萃相对风险（mRR）为0.59（95%置信区间：0.06 - 5.89），存在显著异质性。最高暴露组与最低暴露组的比较也未显示出显著关联（mRR：0.98；95%置信区间：0.64 - 1.50）。两项研究按性别分层的结果显示风险无显著差异。
研究结果表明，基于目前的证据，任何与血清PFOA暴露相关的肾癌风险增加可能都很小且无统计学意义。尽管肾毒性在生物学上具有合理性，但流行病学数据仍无定论。需要进一步开展更大规模人群的研究以及标准化暴露评估，以确定PFOA对肾脏的潜在致癌作用。
