Vugar Ali TÜRKSOY, Zeliha KAYAALTI, Tülin SÖYLEMEZOĞLU, İsmail SAVAŞ, Nalan DEMİR

The evaluation o f arsenic and cadmium levels in biolo gical samples of cases with lung cancer

Giriş: Kronik toksik metal maruziyeti akciğer kanseri nedenleri arasında sigaran ın yan ı sıra önem li b ir ro le sa h iptir. Bu ça lışmanın amacı;biyolo jik örneklerdeki arsenik ve kadmiyum düzeyleriyle akciğerkanserinin histopatolo jik tipleri arasın da ki ilişkiyi de ğerlendirme ktir.Materya l ve Metod: Akciğer kanseri tan ıs ı alan 72 olguda prospektif olara k yapılan bu ça lışma 2009-2013 tarihleri arasın da te k birmerkez de gerçe kleştirildi. Olguların te davi öncesin de alınan biyolojik örne klerin de (kan, saç, idrar) arsenik ve ka dmiyum düzeyleriatomik absorpsiyon spektrometriyle ölçüldü. Akciğer kanserli olguların özellikleri ve metal düzeyleri istatistikse l olara k karşıla ştırıldı(Bu ça lışman ın gücü: 0.74 idi).Bulg ular: Yetmiş iki olgunun (7 K/65 E, ort. yaş : 62.19 ± 8.74 yıl), 56 (%77.8)sı küçük h ücreli dışı akciğer kanseri (KHDAK), 16sıküçük h ücreli akciğer kanseri (KHAK) idi. TNM evrelemesine göre, KHDAKların 27si evre IV, KHAKlı olguların 14ü yaygın h asta -lıktı. Olguların kan, saç ve idrar örneklerin de, orta lama arsenik düzeyleri sırasıyla 23.1 ± 9.2 μg/L , 0.6 ± 0.3 μg/g ve 3.6 ± 1.9 μg/Liken; kadmiyum düzeyleri 1.2 ± 0.8 μg/L , 0.3 ± 0.1 μg/L ve 2.8 ± 1.6 μg/L idi. Kan ile idrar arsenik düze yleri arasın da istatistikselolara k an lamlı ne gatif kore lasyon (r= -0.350; p= 0.025), kan ile saç ka dmiyum düzeyleri arasın da ise pozitif kore lasyon saptan dı (r=-0.371; p= 0.017). Her iki metal düzeyi de (idrar arseniği h ariç) KHDAKlı olgularda; KHAKa göre da ha yüksekti, ancak istatistikselolarak anlamlı de ğildi. TNM evrelemesi ve mortalite aç ısından anlamlı bir ilişki bulunmadı (p> 0.05).Sonuç: Bu çalış mada, biyolojik örne klerdeki arsenik ve ka dmiyum düzeyleriyle a kciğer kanseri tipi, evrelemesi ve morta lite arasın daan lamlı bir ili ki saptanmadı. Da h a ileri çalı malara ih tiyaç olduğu düşünüldü.

Akciğ er kanserli olg uların biyolo jik örneklerinde arsenik ve kadmiyum düzeylerinin de ğerlendirilmesi

In troductio n : Ch ronic exposure to th e toxic meta ls plays an important role among the causes of lun g cancer b eside of smo kin g We g.aime d to eva luate th e association b etween the h istopatho logic type of lun g cancer an d arsenic and ca dmium leve ls in b iolo gica l sa m ples.mpM ate rials an d Meth ods: T h is study in a single center was con ducte d th rough th e years 2009-2013, including 72 patients with lung lcancer, with in a prospective stu dy design. Biolo gica l samples (w h ole bloo d, sca lp h air, urine) of su bjects o b taine d b efore th e treat-trment, an d arsenic an d ca dmium leve ls were ana lyze d b y atomic a b sorption spectroph otometer. T h e ch aracteristics of lun g ca n ce rancases an d meta l leve ls were compare d statistica lly (power: 0.74).Results: Fifty six (77.8%) of patients were non-sma ll ce ll lun g cancer (NSCLC), 16 (22.2%) were sma ll ce ll lun g cancer (SCL C) in C72 stu dy su bjects (7 F/65 M, mean a ge= 62.2 ± 8.7 years). Accordin g to TNM sta gin g, 27 of NSCLC were sta ge IV, 14 of SCLC were wextensive disease. In bloo d, sca lp hair an d urine samples of cases, mean arsenic leve ls were 23.1 ± 9.2 μg/L, 0.6 ± 0.3 μg/g an dd 3.6 d± 1.9 μg/L, while cadmium levels were 1.2 ± 0.8 μg/L, 0.3 ± 0.1 μg/L and 2.8 ± 1.6 μg/L, respectively. A significant ne gativ e cor-erelation was found between blood and urine arsenic levels (r= -0.350; p= 0.025). Blood and hair cadmium levels were also signif can tficpositive corre late d (r= -0.371; p= 0.017). Both of meta l leve ls except of urine arsenic were h igh er in NSCLC patients th an SCLC,SCwith out any statistica l significance. No significance re lation was foun d in terms of TNM sta gin g an d morta lity (p> 0.05).Co n c lus io n: Any difference was o b serve d b etween th e arsenic an d ca dmium leve ls measure d in b io lo gica l samples an d h istopa th o-alo gica l type, sta gin g an d morta lity of patients with lun g cancer in th is stu dy. We th ou gh t that furth er stu dies are nee de d.

PDF

___

1. Beyersmann D, Hartwig A. Carcino genic meta l com- poun ds: recent insigh t into mo lecu lar and ce llu lar mec ha - n isms. Arch Toxico l 2008 ; 82(8):493-512 .
2. ATSDR (Agency for Toxic Su b stances an d Disease Re gistry) Arsenic Toxico lo gica l Profile. Atlanta, GA: ATSDR. 2007. Availa ble at: h ttp://www.atsdr.c dc. gov/ToxProfiles/tp. as p?id=22&tid=3 [accesse d 2 Octo b er 2012].
3. Faroon O, Ash izawa A, Wrigh t S, Tuc ker P, Jen kins K, In german L, et a l. Toxico lo gica l Profile for Ca dmium. Atlanta (GA): Agency for Toxic Su b stances an d Disease Registry (US); 2012 Sep. Availa ble from: h ttp://www.ncb i. nlm.nih . gov/ b oo ks/NBK158838 /
4 . Yosh ida T , Yamauch i H, Fan Sun G. Ch ronic h ea lth effects in people expose d to arsenic via th e drin kin g water: dose - response relationships in review. Toxicol Appl Pharmaco l 2004 ;198 (3 ):243-52 .
5 . Heck JE, An drew AS, One ga T, Rigas JR, Jackson BP, Kara gas MR, et a l. Lun g cancer in a U.S. popu lation with low to mo derate arsenic exposure. Environ Hea lth Perspec t 2009 ;117(11):1718-23 .
6 . Waalkes MP. Cadmium carcino genesis. Mutat Res 2003 ;533(1-2):107-20 .
7. Co b anoglu U, Demir H, Sayir F, Duran M, Mergan D. Some minera l, trace e lement an d h eavy meta l concentra - tions in lun g cancer. Asian Pac J Cancer Pre v 2010 ;11(5):1383-8 .
8. Wa dh wa SK, Kazi TG, Ko lac h i NF , Afridi HI, Kh an S, Chandio AA, et al. Case-control study of male cance r patients expose d to arsenic-contaminate d drin kin g wate r an d to b acco smo ke with re lation to non-expose d cance r patients. Hum Exp Toxico l. 2011;30(12):2013-22. doi: 10.1177/0960327111408154. Epu b 2011 Ma y 9 .
9. García-Esq uinas E, Po llan M, Umans JG, Francesconi KA, Goessler W, Gua llar E, et a l. Arsenic Exposure an d Cance r Morta lity in a US-b ase d Prospective Co h ort: th e Strong H eart Stu dy. Cancer Epidemio l Biomark ers Prev. 2013 ; 22(11):1944-53. doi:10.1158/1055-9965.EPI-13- 0 234-T. Epu b 2013 Oct 17.
10. Kazi TG, Ja lb ani N, Kazi N , Jana li MK, Arain MB, Afridi HI, et a l. Eva luation of toxic meta ls in bloo d an d urine sam ples o f c h ronic rena l failure patient, b efore an d after dia lysis. Ren Fa ll 2008 ;30(7):737-45 .
11. Afridi HI, Kazi TG, Kazi N, Kan dh ro GA, Baig JA, Sh a h AQ, et a l. Eva luation of essentia l trace an d toxic e lements in b io logica l samples. Bio l Trace Elem Res 2011;143(1):20 - 40.
12. Kazi TG , Memon AR, Afridi HI, Jamali MK, Arain MB, Ja lb ani N, et a l. Determination of ca dmium in wh o le bloo d an d sca lp h air samples of Pa kistani ma le lun g cance r patients b y electrothermal atomic absorption spectrometer. Sci Tota l Environ 2008 ; 389(2-3):270-6.
13. Hou J, Ch en G, Wan g Z. Simu ltaneous determination o f trace ca dmium an d arsenic in grains usin g atomic a b sorp- tion spectroph otometry. Guang Pu Xue Yu Guang Pu Fen Xi 2001 ; 21 (3 ):387-90 .
14. Afridi HI, Kazi TG, Jama li MK, Kazi GH , Arain MB, Ja lb an i N, et a l. Eva luation of toxic meta ls in b io lo gica l samples (sca lp h air, bloo d an d urine) of stee l mill work ers by e lec - troth erma l atomic a b sorption spectrometry . Toxico l In d Hea lth 2006 ;22(9):381-93 .
15. Go ldstraw P, Crowle y J, Ch ansky K, Giroux DJ, Groome PA, Rami-Porta R, et a l. ; Internationa l Association for the Stu dy of Lun g Cancer Internationa l Sta gin g Committee; Participating Institutions. T h e IASLC lun g cancer sta ging pro ject: proposa ls for th e revision of TNM sta gin g group- in gs in th e forth comin g (seventh ) e dition of th e TNM c las- sification of th e ma lignant tumours. J T h orac Onco l 2007;2(8):706-14.
16. Ma b uch i K, Lilienfe ld AM, Sne ll LM. Lung cancer among pesticide workers expose d to inorganic arsenica ls. Arch Environ Hea lth 1979 ;34(5):312-20.
17. Elin der CG, Kje llström T, Ho gste dt C, An dersson K, Spång G. Cancer mortality of cadmium workers. Br J Ind Me d 1985 ;42 (10 ):651-5 .
18. To kar EJ, Ben b ra him-Ta llaa L , Waa lkes MP. Meta l ions in h uman cancer deve lo pment. Met Ions Life Sci 2011;8:375 - 4 01 .
19. Krantz A, Dorevitc h S. Meta l exposure an d common ch ronic diseases: a guide for th e clinician. Dis Mon 2004 ;50 (5 ):220-62.
20. Järup L, Ro genfe lt A, Elin der CG, No gawa K, K je llström T. Bio logica l h a lf-time of ca dmium in th e bloo d of work ers after cessation of exposure. Scand J Work Environ Health 1983 ;9 (4 ):327-31 . 21. De Pa lma G, Go ldoni M, Cata lani S, Carb o gnani P, Po li D, Mozzoni P, et a l. Meta llic e lements in pu lmonary b io psies from lung cancer an d contro l su b jects. Acta Biome d 2008;79(Su ppl 1):43-51 .
22. Aposto li P. Elements in environmenta l an d occu pationa l me dicine. J Ch romato gr B Ana lyt Tec h no l Biome d Life Sci 2002 ;778 (1-2 ) :63-97.
23. 't Mannet je A, Benc ko V, Brennan P, Zaridze D, Szeszenia - Da b rowska N, Ru dnai P, et a l. Occu pationa l exposure to meta l compoun ds and lun g cancer. Resu lts from a mu lti- center case-contro l stu dy in Centra l/Eastern Euro pe an d UK. Cancer Causes Contro l 2011 ;22(12):1669-80 .
24. Do ll R, Hill AB. Smo kin g an d carcinoma of th e lun g; pre - liminary re port. Br Me d J 1950;2(4682):739-48.
25. Nordb erg GF. Lun g cancer an d exposure to environmenta l ca dmium. Lancet Onco l 2006 ; 7(2):99-101 .
26. Gerh ardsson L, Nordb erg GF. Lun g cancer in sme lte r workers--interactions of meta ls as in dicate d by tissue leve ls. Scan d J Work Environ Hea lth 1993;19(Su ppl 1):90-4.
27. Wysowski DK, Lan drigan PJ, Ferguson SW, Fontaine RE, Tson gas TA, Porter B. Ca dmium exposure in a community n ear a sme lter. Am J Epidemio l 1978;107(1):27-35 .
28. E l-Agh a O, Gö kmen IG. Smo kin g h a b its an d ca dmium inta k e in Turk e y. Bio l Trace Elem Res 2002;88(1):31-43.
29. Samet JM, Avila-Tan g E, Boffetta P, Hannan LM, O livo - Marston S, T h un MJ, et a l. Lun g cancer in never smo kers: c linica l epidemio lo gy an d environmenta l risk factors. Clin Cancer Res 2009 ;15(18):5626-45.
30. Guo HR, Wan g NS, Hu H, Monson RR. Ce ll type specific- ity of lung cancer associate d with arsenic ingestion. Cance r Epidemio l Biomarkers Prev 2004;13(4):638-43.
31. Lauwerys R, Roe ls H, Re gniers M, Buch et JP, Bernard A, Goret A. Significance of ca dmium concentration in bloo d and in urine in workers expose d to ca dmium. Environ Res 1979 ;20 (2 ) :375-91 .
32. Brima EI, Haris PI, Jen kins RO, Po ly a DA, Gau lt AG, H arrin gton CF. Un derstan din g arsenic meta b o lism th rou gh a com parative stu dy of arsenic leve ls in th e urine, h air an d fin gernails of healthy volunteers from three unexpose d eth nic groups in th e Unite d Kin gdom. Toxico l Appl Ph armaco l 2006;216(1):122-30. Epu b 2006 Jun 8 .
33. Adams SV, Passarelli MN, Newcomb PA. Cadmium expo - sure and cancer mortality in the Third National Health an d Nutrition Examination Surve y co h ort. Occu p Environ Me d 2012 ;69(2):153-6 .
34. Park RM, Sta yner LT, Petersen MR, Finle y-Couch M, H ornun g R, Rice C. Cadmium and lun g cancer mortality accountin g for simu ltaneous arsenic exposure. Occup E nviron Me d 2012 ; 69(5):303-9.
35. Na ka daira H, En do h K, Kata giri M, Yamamoto M. Elevate d morta lity from lung cancer associate d with arsenic expo - sure for a limite d duration. J Occu p Environ Me d 2002 ;44(3):291-9 .
36. Lee-Fe ldstein A. Cumu lative exposure to arsenic an d its re lationsh ip to respiratory cancer amon g copper sme lte r em plo yees. J Occu p Me d 1986;28(4):296-302.
37. Sora h an T, Esmen NA. Lun g cancer morta lity in UK nick e l- ca dmium b attery workers, 1947-2000. Occu p Environ Me d 2004 ;61(2):108-16.
38. Sora h an T, Lister A, Gilth orpe MS, Harrington JM. Morta lity of co pper ca dmium a llo y work ers with specia l reference to lun g cancer an d non-ma lignant diseases of th e respiratory system, 1946-92. Occu p Environ Med 1995;52(12):804 - 81 2 .
39. Li Q, Nish i jo M, Na k a gawa H, Morikawa Y, Sa kurai M, Na kamura K, et a l. Re lations hip b etween urinary ca dmium an d morta lity in h a b itants of a ca dmium-po llute d area: a 22-year fo llow-up stu dy in Japan. Ch in Me d J (Engl) 2 011 ;124 (21 ):3504-9 .
40. Akb u lut NE, Tuncer AM. Accumu lation of h eavy meta ls with water q ua lity parameters in Kızılırma k River Basin (De lice River) in Turke y. Environ Monit Assess 2011;173(1 - 4):387-95 .