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Luvián-Morales J, Gutiérrez-Enríquez SO, Granados-García V, Torres-Poveda K. Risk factors for the development of cervical cancer: analysis of the evidence. Front Oncol 2024; 14:1378549. [PMID: 38846977 PMCID: PMC11153748 DOI: 10.3389/fonc.2024.1378549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Cervical cancer (CC) is the fourth most prevalent female cancer globally. Understanding its epidemiology is crucial for devising practical strategies suited to geographic and social contexts to attain the global eradication of CC. Hence, this study examined the latest evidence of risk factors contributing to CC development. Methods An independent literature search was conducted on PubMed using MESH terms. The primary sources were meta-analyses published from 2010 to 2023, which detail updated evidence on risk factors associated with CC. Additionally, the quality of the evidence was evaluated using the GRADE system and recommendations were made accordingly. Results The main risk factors related to the cause of CC include co-infections with other sexually transmitted infections, genetic markers, cervicovaginal microbiota, nutritional factors, comorbidities that affect the immune response, smoking, and the use of hormonal contraceptives with a quality evidence based on the GRADE scale moderate. Conclusions Since the necessary cause for CC is persistent cervicovaginal HPV, all the risk factors implicated in the causality of CC act as non-independent cofactors that increase the risk of CC. Thus, changes in public policies aimed at addressing these risk factors are highly recommended and can substantially decrease the risk of CC.
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Affiliation(s)
| | | | - Víctor Granados-García
- Epidemiological and Health Services Research Unit Aging Area, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Kirvis Torres-Poveda
- Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
- Consejo Nacional de Humanidades Ciencias y Tecnologías (CONAHCYT)-INSP, Cuernavaca, Mexico
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2
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Bowden SJ, Doulgeraki T, Bouras E, Markozannes G, Athanasiou A, Grout-Smith H, Kechagias KS, Ellis LB, Zuber V, Chadeau-Hyam M, Flanagan JM, Tsilidis KK, Kalliala I, Kyrgiou M. Risk factors for human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer: an umbrella review and follow-up Mendelian randomisation studies. BMC Med 2023; 21:274. [PMID: 37501128 PMCID: PMC10375747 DOI: 10.1186/s12916-023-02965-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Persistent infection by oncogenic human papillomavirus (HPV) is necessary although not sufficient for development of cervical cancer. Behavioural, environmental, or comorbid exposures may promote or protect against malignant transformation. Randomised evidence is limited and the validity of observational studies describing these associations remains unclear. METHODS In this umbrella review, we searched electronic databases to identify meta-analyses of observational studies that evaluated risk or protective factors and the incidence of HPV infection, cervical intra-epithelial neoplasia (CIN), cervical cancer incidence and mortality. Following re-analysis, evidence was classified and graded based on a pre-defined set of statistical criteria. Quality was assessed with AMSTAR-2. For all associations graded as weak evidence or above, with available genetic instruments, we also performed Mendelian randomisation to examine the potential causal effect of modifiable exposures with risk of cervical cancer. The protocol for this study was registered on PROSPERO (CRD42020189995). RESULTS We included 171 meta-analyses of different exposure contrasts from 50 studies. Systemic immunosuppression including HIV infection (RR = 2.20 (95% CI = 1.89-2.54)) and immunosuppressive medications for inflammatory bowel disease (RR = 1.33 (95% CI = 1.27-1.39)), as well as an altered vaginal microbiome (RR = 1.59 (95% CI = 1.40-1.81)), were supported by strong and highly suggestive evidence for an association with HPV persistence, CIN or cervical cancer. Smoking, number of sexual partners and young age at first pregnancy were supported by highly suggestive evidence and confirmed by Mendelian randomisation. CONCLUSIONS Our main analysis supported the association of systemic (HIV infection, immunosuppressive medications) and local immunosuppression (altered vaginal microbiota) with increased risk for worse HPV and cervical disease outcomes. Mendelian randomisation confirmed the link for genetically predicted lifetime smoking index, and young age at first pregnancy with cervical cancer, highlighting also that observational evidence can hide different inherent biases. This evidence strengthens the need for more frequent HPV screening in people with immunosuppression, further investigation of the vaginal microbiome and access to sexual health services.
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Affiliation(s)
- Sarah J Bowden
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK.
- Queen Charlotte's and Chelsea - Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - Triada Doulgeraki
- Queen Charlotte's and Chelsea - Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Antonios Athanasiou
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
| | - Harriet Grout-Smith
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
| | - Konstantinos S Kechagias
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
| | - Laura Burney Ellis
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
- Queen Charlotte's and Chelsea - Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - James M Flanagan
- Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ilkka Kalliala
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maria Kyrgiou
- Department of Metabolism, Digestion and Reproduction and Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, Hammersmith Hospital campus, London, W12 0HS, UK
- Queen Charlotte's and Chelsea - Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
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Golara A, Kozłowski M, Guzik P, Kwiatkowski S, Cymbaluk-Płoska A. The Role of Selenium and Manganese in the Formation, Diagnosis and Treatment of Cervical, Endometrial and Ovarian Cancer. Int J Mol Sci 2023; 24:10887. [PMID: 37446063 DOI: 10.3390/ijms241310887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Selenium (Se) and manganese (Mn) are essential micronutrients that are important elements of cell metabolism. They are involved in the composition of enzyme systems and regulate enzyme activity. Disturbances in the homeostasis of these micronutrients affect the development of many diseases and carcinogenesis, which can be linked to increased levels of oxidative stress and impaired antioxidant properties of many enzymes. Selenium has a very important function in maintaining immune-endocrine, metabolic and cellular homeostasis. Manganese, on the other hand, is important in development, digestion, reproduction, antioxidant defense, energy production, immune response and regulation of neuronal activity. We review the role of selenium and manganese and their effects on tumor growth, metastasis potential and remodeling of the microenvironment. We also describe their role as potential biomarkers in the diagnosis and the potential for the use of Se- and Mn-containing compounds in composition for the treatment of cancer of the reproductive organs.
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Affiliation(s)
- Anna Golara
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Mateusz Kozłowski
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Paweł Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Li XY, Li G, Gong TT, Lv JL, Gao C, Liu FH, Zhao YH, Wu QJ. Non-Genetic Factors and Risk of Cervical Cancer: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies. Int J Public Health 2023; 68:1605198. [PMID: 37065642 PMCID: PMC10103589 DOI: 10.3389/ijph.2023.1605198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
Objectives: The association between non-genetic risk factors and cervical cancer (CC) remains controversial and unclear. This umbrella review was conducted to evaluate and synthesize previously published systematic reviews and meta-analyses related to non-genetic factors and CC risk.Methods: We searched PubMed, Web of Science, and EMBASE to identify studies investigating the association between extragenetic factors and CC risk. For each article, we calculated the summary effect size and the 95% confidence interval. Specific criteria were used to classify the association into four levels: strong, highly suggestive, suggestive, or weak.Results: A total of 18 meta-analyses of different risk factors for CC were examined; these studies covered risk factors related to diet, lifestyle, reproduction, disease, viral infection, microorganisms, and parasites. Oral contraceptive use and Chlamydia trachomatis infection were shown to increase CC risk, and this was supported by strong evidence. Additionally, there were four risk factors supported by highly suggestive evidence and six risk factors supported by suggestive evidence.Conclusion: In conclusion, there is a strong association between oral contraceptive use, Chlamydia trachomatis infection, and increased CC risk.
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Affiliation(s)
- Xin-Yu Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Gang Li
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Le Lv
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qi-Jun Wu,
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Sravani AB, Ghate V, Lewis S. Human papillomavirus infection, cervical cancer and the less explored role of trace elements. Biol Trace Elem Res 2023; 201:1026-1050. [PMID: 35467267 PMCID: PMC9898429 DOI: 10.1007/s12011-022-03226-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/29/2022] [Indexed: 02/06/2023]
Abstract
Cervical cancer is an aggressive type of cancer affecting women worldwide. Many affected individuals rely on smear tests for the diagnosis, surgery, chemotherapy, or radiation for their treatment. However, due to a broad set of undesired results and side-effects associated with the existing protocols, the search for better diagnostic and therapeutic interventions is a never-ending pursuit. In the purview, the bio-concentration of trace elements (copper, selenium, zinc, iron, arsenic, manganese, and cadmium) is seen to fluctuate during the occurrence of cervical cancer and its progression from pre-cancerous to metastatic nature. Thus, during the occurrence of cervical cancer, the detection of trace elements and their supplementation will prove to be highly advantageous in developing diagnostic tools and therapeutics, respectively. This review provides a detailed overview of cervical cancer, its encouragement by human papillomavirus infections, the mechanism of pathology, and resistance. Majorly, the review emphasizes the less explored role of trace elements, their contribution to the growth and inhibition of cervical cancer. Numerous clinical trials have been listed, thereby providing a comprehensive reference to the exploration of trace elements in the management of cervical cancer.
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Affiliation(s)
- Anne Boyina Sravani
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Vivek Ghate
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Shaila Lewis
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
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An Assessment of Serum Selenium Concentration in Women with Ovarian Cancer. Nutrients 2023; 15:nu15040850. [PMID: 36839209 PMCID: PMC9963663 DOI: 10.3390/nu15040850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Available studies on the effect of serum selenium levels on the risk of malignancies show some conflicting results. In this study, we investigated the correlation between serum selenium levels and ovarian cancer occurrence. METHODS 314 women (157 diseased patients and 157 healthy ones) matched in terms of age and BMI were included in the study. The measurements of selenium in the collected blood samples were performed using an ICP mass spectrometer. Univariable and multivariable analyzes were performed to determine the relationship between the factors under the study and the occurrence of ovarian cancer. RESULTS The mean concentration of selenium was lower among diseased ones than among controls (53.31 μg/L vs. 78.99 μg/L). A decrease in selenium concentration was noticed with the advancement of ovarian cancer. In univariable and multivariable analyzes, a clear relationship between low selenium concentration and the occurrence of ovarian cancer was found (35.3 (95% CI: 11.2-111; p < 0.001) and 45.8 (95% CI: 12.8-164; p < 0.001)). CONCLUSION The studied patients with ovarian cancer are characterized by statistically significant lower serum selenium levels than patients from the control group. Among the study group, a decrease in selenium concentration was observed with an increase in the FIGO stage. The determination of the role of selenium as a prophylactic factor in ovarian cancer requires further prospective studies.
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7
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Shengyu C, Yinhua L, Yuanhong L, Jinbo Z, Can F, Hao X, Changjiang Z. Selenium alleviates heart remodeling through Sirt1/AKT/GSK-3β pathway. Int Immunopharmacol 2022; 111:109158. [PMID: 35987147 DOI: 10.1016/j.intimp.2022.109158] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 11/05/2022]
Abstract
Selenium, reported as an important medium for maintaining the body's homeostasis, acts to have multiple bioeffects including anti-inflammatory, anti-oxidant and anti-apoptosis effects. However, its role in heart failure still remains unclear. In this study, we explored the effects of selenium on heart failure and its possible mechanism. The heart failure models were induced by aortic banding and isoproterenol. H&E, TUNEL and PSR staining were performed to detect the degree of cardiomyocyte hypertrophy, apoptosis rates and heart fibrosis, respectively. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect different mRNA levels, and western blot was applied to assess the expressions of relative proteins. Immunofluorescence staining was used to evaluate α-SMA density. We first found that treatment of selenium alleviated heart fibrosis and the development of heart failure but not cardiomyocyte cross sectional areas. Besides, selenium improved heart levels of superoxide dismutase2 (SOD2), glutathione peroxidase (Gpx) and glutathione (GSH) and the activity of SOD, accompanied by decreased apoptosis rate. In addition, our in vitro study has shown that selenium reduced mRNA levels of collagen Ⅰ and collagen III, expressions of a-SMA, p-AKT/AKT and p-GSK-3β/ GSK-3β, apoptosis rates and reactive oxygen species (ROS) levels in H9C2 cardio-myoblasts treated with TGF-β1. Moreover, the level of Sirt1 was found to be up-regulated by selenium which effects were weakened after the administration of small interfering RNA (siRNA)-Sirt1 or EX527 (inhibitor of Sirt1). Our current results have demonstrated that the protective effects of selenium on heart hypertrophy is through the regulation of Sirt1 and AKT/GSK-3β pathway.
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Affiliation(s)
- Cui Shengyu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Luo Yinhua
- Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, China
| | - Li Yuanhong
- Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, China
| | - Zhao Jinbo
- Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, China
| | - Fang Can
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Xia Hao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China.
| | - Zhang Changjiang
- Department of Cardiology, Minda Hospital of Hubei Minzu University, Enshi, China.
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Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers-A State-of-the-Art Review. Nutrients 2021; 14:nu14010185. [PMID: 35011060 PMCID: PMC8746721 DOI: 10.3390/nu14010185] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
Gynecological neoplasms pose a serious threat to women's health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.
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Liu X, Wang Y, Han S, Zhang Y, Zou Y, Su S, Zhou H, Zhang X, Liang H, Hou J, Wang T. A Spatial Ecological Study on Serum Selenium and Keshan Disease in Heilongjiang Province, China. Biol Trace Elem Res 2021; 199:3253-3261. [PMID: 33159624 DOI: 10.1007/s12011-020-02478-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/03/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND There are no reports on the spatial ecology of serum selenium and Keshan disease in Heilongjiang Province in China. OBJECTIVE This study aimed to conduct a spatial assessment of Keshan disease elimination at the level of the etiological molecular marker. METHODS An ecological study design was used. The levels of serum selenium of the 571 residents aged between 17 and 35 years and living in rural areas, townships, and cities in 63 Keshan disease endemic counties and 46 non-endemic counties in Heilongjiang Province were measured using atomic fluorescence spectrometry. A spatial analysis of serum selenium levels was conducted. RESULTS The median serum selenium level of the 571 participants was 1.00 μmol/L, and that of participants living in Keshan disease endemic areas was 0.97 μmol/L, which was significantly lower compared to the level of those living in non-endemic areas (1.01 μmol/L, P = 0.0037). Serum selenium levels of the participants living in rural areas, townships, and cities were significantly different (P < 0.001) at 0.95 μmol/L, 1.00 μmol/L, and 1.04 μmol/L, respectively. Spatial regression analysis showed that the distribution of serum selenium levels was positively correlated with the per capita gross domestic product. CONCLUSION The analysis of the spatial distribution of serum selenium levels provided precise visual evidence that selenium deficiency may still be present among residents of Keshan disease endemic counties of Tangyuan, Mulan, Lingdong, Suiling, and Dongshan. Selenium levels should therefore be included in the national surveillance of Keshan disease.
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Affiliation(s)
- Xu Liu
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Yanan Wang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Shan Han
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Yiyi Zhang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Yuanjie Zou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Shengqi Su
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Huihui Zhou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Jining Medical University, Jining, China
| | - Xiao Zhang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Qingdao Municipal Hospital, Qingdao, China
| | - Hong Liang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
- Qiqihar Medical University, Qiqihar, China
| | - Jie Hou
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China
| | - Tong Wang
- Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, 157 Baojian Road, Harbin, 150081, People's Republic of China.
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Jablonska E, Li Q, Reszka E, Wieczorek E, Tarhonska K, Wang T. Therapeutic Potential of Selenium and Selenium Compounds in Cervical Cancer. Cancer Control 2021; 28:10732748211001808. [PMID: 33754876 PMCID: PMC8204638 DOI: 10.1177/10732748211001808] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Cervical cancer is a common female cancer. It is strongly associated with human papillomavirus (HPV) infection. However, HPV infection alone is not sufficient to induce cervical cancer because its development is dependent on the coexistence of several factors that enable the virus to overcome the host immune system. These include individual genetic background, environmental factors, or diet, including dietary selenium intake. Selenium is an essential trace element with antiviral properties and has been shown to exert antitumor effects. Surprisingly, the role of selenium in cervical cancer has not been studied as intensively as in other cancers. Here, we have summarized the existing experimental data on selenium and cervical cancer. It may be helpful in evaluating the role of this nutrient in treatment of the mentioned malignancy as well as in planning further studies in this area.
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Affiliation(s)
- Ewa Jablonska
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Qi Li
- Department of Gynecological Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Edyta Reszka
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Edyta Wieczorek
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Kateryna Tarhonska
- Department of Translational Research, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Tong Wang
- Harbin Medical University, Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University, Harbin, China
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The Role of Zinc and Copper in Gynecological Malignancies. Nutrients 2020; 12:nu12123732. [PMID: 33287452 PMCID: PMC7761859 DOI: 10.3390/nu12123732] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Zinc (Zn) and copper (Cu) are essential microelements, which take part in cellular metabolism, feature in enzymatic systems, and regulate enzyme activity. Homeostasis of these micronutrients is tightly regulated by multiple compensatory mechanisms that balance their concentrations including transporters, importers, and metallothioneins. An altered intake of only one of these trace elements may cause an imbalance in their levels and result in their competition for absorption. Relatively low levels of zinc and increased levels of copper may result in an increased level of oxidative stress and impair the antioxidant properties of multiple enzymes. Altered levels of trace elements were discovered in various pathologies including immunological, degenerative, and inflammatory diseases. Moreover, due to the role of Zn and Cu in oxidative stress and chronic inflammation, they were found to influence cancerogenesis. We review the roles of zinc and copper and their mechanisms in tumor growth, metastasis potential, microenvironment remodeling, and drug resistance. We highlight their role as potential biomarkers for cancer diagnosis, treatment, and prognosis, concentrating on their impact on gynecological malignancies.
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Meng Y, Sun J, Yu J, Wang C, Su J. Dietary Intakes of Calcium, Iron, Magnesium, and Potassium Elements and the Risk of Colorectal Cancer: a Meta-Analysis. Biol Trace Elem Res 2019; 189:325-335. [PMID: 30171595 DOI: 10.1007/s12011-018-1474-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to analyze the existing studies and to investigate the relationship between the risk of colorectal cancer (CRC) and intakes of four individual dietary elements calcium (Ca), iron (Fe), magnesium (Mg), and potassium (K). All relevant articles in both Chinese and English were searched and collected from PubMed, Web of Science, and Chinese National Knowledge Infrastructure databases up to December 17, 2017. There were 29 eligible literatures selected for further meta-analysis, including 14 cohort studies and 15 case-control studies. The meta-analysis of cohort studies indicated that the high intakes of dietary Ca and Mg were negatively associated with the risk of CRC, as the hazard ratios (HR) were 0.76 (95% confidence interval (CI) 0.72, 0.80) and 0.80 (95% CI 0.73, 0.87), respectively. Nevertheless, high intake of dietary heme Fe was positively correlated to the incidence of colon cancer (HR = 1.01, 95% CI 0.82, 1.19) and rectal cancer (HR = 1.04, 95% CI 0.67, 1.42). A meta-analysis of case-control studies indicated that high intakes of dietary Ca, Mg, and K were negatively related with the occurrence of CRC, because the odds ratios (OR) were 0.36 (95% CI 0.32, 0.40), 0.80 (95% CI 0.63, 0.98) and 0.97 (95% CI 0.74, 1.21), respectively. However, high Fe intake from diet was positively correlated with the rising increasing of CRC (OR = 1.04, 95% CI 0.91, 1.18). More research is needed to indicate the risk relationship between element intake and CRC.
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Affiliation(s)
- Yu Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan, 430071, Hubei, People's Republic of China
| | - Jiantao Sun
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan, 430071, Hubei, People's Republic of China
| | - Jun Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan, 430071, Hubei, People's Republic of China
| | - Chunhong Wang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan, 430071, Hubei, People's Republic of China
| | - Jianmei Su
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan, 430071, Hubei, People's Republic of China.
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Obhielo E, Ezeanochie M, Olokor O O, Okonkwo A, Gharoro E. The Relationship between the Serum Level of Selenium and Cervical Intraepithelial Neoplasia: A Comparative Study in a Population of Nigerian Women. Asian Pac J Cancer Prev 2019; 20:1433-1436. [PMID: 31127904 PMCID: PMC6857890 DOI: 10.31557/apjcp.2019.20.5.1433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To determine the relationship between the serum level of selenium and cervical intraepithelial neoplasia
(CIN). Methods: A case controlled study that compared the serum level of selenium in 45 women with CIN (cases) to
45 women (age matched controls) with normal cervical cytology. Socio-demographic data and information on known
risk factors for cervical cancer among the sample was compared between both groups using inferential statistics.
Results: There was no significant difference in the mean selenium values between the cases and controls [p- 0.076,
95% CI (-15.08 – 0.76)]. However, subgroup analysis showed a statistically significant difference between patients
with normal cervical cytology, CIN I, II and III (p= 0.021). In addition, there was also significant difference in the
selenium level between women with normal cervical cytology and CIN III (p value = 0.016) with a significant inverse
linear trend (p= 0.025). Conclusion: With increasing severity of CIN, a significant reduction in the level of selenium
in serum was observed. This reducing value of serum selenium, a surrogate marker for increased oxidative stress, may
be important factor for the development of persistent HPV infection and in particular high grade CIN III lesions. This
observation requires further research.
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Affiliation(s)
| | - Michael Ezeanochie
- Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria.
| | - Oghenefegor Olokor O
- Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria.
| | - Anthony Okonkwo
- Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria.
| | - Etedafe Gharoro
- Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria.
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Xie Y, Wang J, Zhao X, Zhou X, Nie X, Li C, Huang F, Yuan H. Higher serum zinc levels may reduce the risk of cervical cancer in Asian women: A meta-analysis. J Int Med Res 2018; 46:4898-4906. [PMID: 30370809 PMCID: PMC6300959 DOI: 10.1177/0300060518805600] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objective This meta-analysis was conducted to examine the possible association between serum zinc concentration and cervical cancer risk. Methods PubMed, WanFang, China National Knowledge Infrastructure, and SinoMed databases were searched for relevant articles published between January 1980 and September 2017. Results were combined using a random-effects model, and pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated to compare serum zinc levels in patients with cervical cancer versus controls. Publication bias was evaluated using Begg’s funnel plot and Egger’s regression asymmetry test. Results Twelve articles regarding serum zinc levels and cervical cancer were included in this meta-analysis. Combined results showed that serum zinc levels in cervical cancer cases were significantly lower than in controls without cervical cancer (summary SMD –1.379, 95% CI –1.527, –1.231), with high heterogeneity (I2 = 98.8%). Analysis of data stratified by geographic location showed a significant association between serum zinc levels and cervical cancer risk in Asian populations (summary SMD –1.391, 95% CI –1.543, –1.239). Conclusions Higher serum zinc levels may be a protective factor for cervical cancer in Asian women.
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Affiliation(s)
- Yueying Xie
- Department of Pathology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Junjie Wang
- Department of Gynaecology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Xiaoya Zhao
- Department of Pathology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Xuli Zhou
- Department of Pathology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Xiaohui Nie
- Department of Gynaecology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Chuncheng Li
- Department of Pathology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Fulian Huang
- Department of Gynaecology, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
| | - Haibin Yuan
- Department of Paediatrics, the Maternal and Child Health Care Hospital of Xiangtan City, Hunan Province, China
- Haibin Yuan, Department of Paediatrics, the Maternal and Child Health Care Hospital of Xiangtan City, 295 East Lake Road, Xiangtan, Hunan Province, 411104, China.
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Úriz A, Sanmartín C, Plano D, de Melo Barbosa R, Dreiss CA, González-Gaitano G. Activity enhancement of selective antitumoral selenodiazoles formulated with poloxamine micelles. Colloids Surf B Biointerfaces 2018; 170:463-469. [DOI: 10.1016/j.colsurfb.2018.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/21/2018] [Accepted: 06/06/2018] [Indexed: 01/07/2023]
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Abstract
Whether serum copper levels were higher in patients with cervical cancer than that in controls was controversial. Hence, we conducted the present study to explore the relationship between serum copper levels and cervical cancer. We searched PubMed, WanFang, and China National Knowledge Internet (CNKI) for relevant studies before November 30, 2017. Standardized mean difference (SMD) and 95% confidence interval (CI) were used to combine results across studies using the random-effect model. A total of 14 publications involving 747 patients with cervical cancer and 1014 controls were eligible through inclusion criteria. In comparison with controls, serum copper levels were significantly higher in patients with cervical cancer [summary SMD = 1.35; 95%CI: 0.10–2.59], with significant heterogeneity (I2 = 98.8%; P<0.001) was found. Significant association was also found among Asian populations [summary SMD = 1.39; 95%CI: 0.06–2.71]. The association was positive in subgroup analysis of population-based case–control studies (PBCC) [summary SMD = 1.64; 95%CI: 0.02–3.34], but not in hospital-based case–control studies (HBCC). Through a sensitivity analysis, we did not identify any single study to strongly influence the results of our serum copper levels and cervical cancer risk. No publication bias was found in our analysis. In conclusion, our study provided significant evidence of higher serum copper levels in patients with cervical cancer than in controls, suggesting that serum copper exposure was a risk factor on cervical cancer.
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Lubiński J, Marciniak W, Muszynska M, Jaworowska E, Sulikowski M, Jakubowska A, Kaczmarek K, Sukiennicki G, Falco M, Baszuk P, Mojsiewicz M, Kotsopoulos J, Sun P, Narod SA, Lubiński JA. Serum selenium levels and the risk of progression of laryngeal cancer. PLoS One 2018; 13:e0184873. [PMID: 29304040 PMCID: PMC5755727 DOI: 10.1371/journal.pone.0184873] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/03/2017] [Indexed: 12/31/2022] Open
Abstract
Background Observational studies have reported an inverse relationship between selenium status (blood or toenail) and the risk of laryngeal cancer; however, the impact of low serum selenium level on survival has not been evaluated. Methods We conducted a prospective study of 296 patients diagnosed with laryngeal cancer in Szczecin, Poland. Serum selenium was measured at diagnosis and prior to treatment. Patients were followed from the date of diagnosis to death at five years. Vital status was obtained by linkage to the Polish National Death Registry. Results The five-year survival after diagnosis was 82.0% (95% CI: 68% to 91%) for individuals in the highest quartile of serum selenium (> 66.8 μg/L) and was 28.6% (95% CI 19% to 42%) for individuals in the lowest quartile (<50.0 μg/L). In an age- and sex-adjusted analysis, the hazard ratio (HR) for death from all causes was 7.01 (95% CI 3.81 to 12.9) for patients in the lowest quartile of serum selenium, compared to those in the highest quartile. The corresponding multivariate HR was 3.07 (95% CI 1.59 to 5.94). Conclusions This study suggests that a selenium level in excess of 70 μg/L is associated with improved outcome among patients undergoing treatment for laryngeal cancer. Further studies are needed to evaluate if selenium supplementation to achieve this level might improve overall prognosis.
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Affiliation(s)
- Jan Lubiński
- Clinic of Otolaryngology, Pomeranian Medical University, Szczecin, Poland
- ReadGene, Grzepnica, Poland
| | - Wojciech Marciniak
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Magdalena Muszynska
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Jaworowska
- Clinic of Otolaryngology, Pomeranian Medical University, Szczecin, Poland
| | | | - Anna Jakubowska
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Kaczmarek
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Grzegorz Sukiennicki
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Michal Falco
- Regional Oncology Centre Szczecin, Szczecin, Poland
| | - Piotr Baszuk
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Magdalena Mojsiewicz
- Institute of Econometric and Statistics, University of Szczecin, Szczecin, Poland
| | - Joanne Kotsopoulos
- Women’s College Research Institute, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ping Sun
- Women’s College Research Institute, Toronto, Canada
| | - Steven A. Narod
- Women’s College Research Institute, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- * E-mail: (SN); (JAL)
| | - Jan A. Lubiński
- ReadGene, Grzepnica, Poland
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- * E-mail: (SN); (JAL)
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Cardoso BR, Duarte GBS, Reis BZ, Cozzolino SMF. Brazil nuts: Nutritional composition, health benefits and safety aspects. Food Res Int 2017; 100:9-18. [PMID: 28888463 DOI: 10.1016/j.foodres.2017.08.036] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/11/2017] [Accepted: 08/13/2017] [Indexed: 12/15/2022]
Abstract
Brazil nuts are among the richest selenium food sources, and studies have considered this Amazonian nut as an alternative for selenium supplementation. Besides selenium, Brazil nuts present relevant content of other micronutrients such as magnesium, copper, and zinc. The nutritional composition of nuts, also characterized by adequate fatty acid profile and high content of protein and bioactive compounds, has many health benefits. In the present review, we examine the nutritional composition of Brazil nuts, comparing it with other nuts, and describe the relevance of possible contaminants and metal toxicants observed in this nut for human health. Furthermore, we report different trials available in the literature, which demonstrate positive outcomes such as modulation of the lipid serum profile, enhancement of the antioxidant system and improvement of anti-inflammatory response. These effects have been assessed under different conditions, such as cognitive impairment, dyslipidemia, cancer, and renal failure.
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Affiliation(s)
- Bárbara R Cardoso
- Nutrition and Minerals Laboratory, Dept. of Food and Experimental Nutrition, University of São Paulo, São Paulo, Brazil; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Graziela B Silva Duarte
- Nutrition and Minerals Laboratory, Dept. of Food and Experimental Nutrition, University of São Paulo, São Paulo, Brazil
| | - Bruna Z Reis
- Nutrition and Minerals Laboratory, Dept. of Food and Experimental Nutrition, University of São Paulo, São Paulo, Brazil
| | - Silvia M F Cozzolino
- Nutrition and Minerals Laboratory, Dept. of Food and Experimental Nutrition, University of São Paulo, São Paulo, Brazil
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