云南曲靖地区铜的暴露与肺癌相关性研究

我国云南省曲靖的宣威和富源等地是全世界肺癌高发区,为了研究环境介质中铜(Cu)等重金属的暴露与体内分布特征,探讨Cu与肺癌的相关性,在当地开展肺癌环境流行病学调查,采集宣威和富源高发区人群饮食、饮水以及人体血浆和肺组织样品,微波消解ICP-MS法测定样品中Cu等元素.结果显示,当地居民使用燃料类型是影响肺癌高发的重要因素.高发区人群Cu的日摄入总量低于我国推荐的每日膳食中营养素供给量(RDA).肺癌组血液中Cu含量显著高于对照组,肺癌组织中Cu含量显著高于癌旁组织和正常组织,且肺癌患者的血浆和肺组织中Cu/Zn比值均升高.Pearson相关性分析结果表明,Cu和Ni、Cu和Pb呈显著正相关,提示在致癌作用上具有协同效应;Cu和Fe、Cu和Zn呈显著负相关,提示具有抑制或拮抗作用.多因素Logistic回归结果表明,Cu是肺癌发生的重要影响因素,人体中Cu含量和Cu/Zn比值可为肺癌的早期预防和诊断提供科学依据.

Study on the Relationship between Copper Exposure and Lung Cancer in Qujing Area, Yunnan Province

Xuanwei and Fuyuan, located in Qujing, Yunnan province, were found as areas with the highest lung cancer incidence worldwide. The relationships of the copper distribution and lung cancer incidence were investigated in the areas with high lung cancer communes. Water, food, human plasma and lung tissue samples were collected and analyzed for the copper contents using microwave digestion-ICP-MS. The results showed that fuel type is the most important factor influencing lung cancer occurrence. The total daily intake of copper was lower than Recommended Dietary Allowance (RDA) in high lung cancer incidence areas. Copper concentrations in plasma samples from lung cancer patients were significantly higher than those in the control samples. The concentrations of copper in lung cancer tissues were also higher than those in paracancerous lung tissues and benign lung tissues. Ratio of Cu/Zn increased in both plasma and lung cancer tissue. The results of Pearson multiple correlation analysis showed that there was a significant positive correlation between Cu and Ni, Cu and Pb respectively, which indicated that these elements had synergism of anticarcinogenic effects or carcinogenesis. Cu and Fe, Cu and Zn were negatively correlated to each other. It indicated that the elements had some effects of antagonism. The results of logistic regression showed that copper might be the important factor for lung cancer occurrence.