A pilot study examining the relationship between environmental contaminants and colorectal cancer at a single medical institute in Taiwan

環境汙染物與大腸直腸癌關聯性之台灣單一醫學中心前驅性研究

儲天輝(Tian-Huei Chu) ； 周育緯(Yu-Wei Chou) ； 林聖倫(Sheng-Lun Lin) ； 林淑芬(Su-Fan Lin) ； 陳鴻華(Hong-Hwa Chen) ； 胡萬祥(Wan-Hsiang Hu) ； 陳彥仰(Yen-Yang Chen) ； 張簡國平(Guo-Ping Chang-Chien) ； 張峻桓(Jyun-Huan Chang) ； 蔡孟錡(Meng-Chi Tsai) ； 黃昭誠(Chao-Cheng Huang)

《台灣公共衛生雜誌》 40卷4期 (2021/08) Pp. 382-393

https://doi.org/10.6288/TJPH.202108_40(4).110037

摘要

Objectives: Colorectal cancer (CRC) is a major health problem with high incidence and mortality rates worldwide. The increased incidence of CRC in Taiwan may be associated with environmental contaminants such as polycyclic aromatic hydrocarbons (PAHs), nitrate, and nitrite. Accordingly, in this study, the relationship between these contaminants and CRC was investigated. Methods: Paired plasma and tumor tissues of CRC patients were obtained from the Tissue Bank at Kaohsiung Chang Gung Memorial Hospital. The samples were extracted and analyzed using enzyme-linked immunosorbent assay and gas chromatography-tandem mass spectrometry for detecting the concentrations of nitrate/nitrite and 16 types of PAHs, respectively, at the Super Micro Mass Research & Technology Center, Cheng Shiu University. Results: Nitrite and the 16 types of PAHs were undetectable in the plasma; thus, only nitrate was selected for further investigation. The data indicated that the plasma levels of nitrate were not significantly different between the CRC and control groups. Notably, the average levels of nitrate in tumor tissues were significantly higher than the average plasma levels, but the nitrate levels in paired plasma and tumor tissues did not show a significant correlation. Moreover, no significant difference in the nitrate levels of plasma and tumor tissues was found in patients with different tumor stages. Conclusions: In this pilot study, no significant correlation was found between the nitrate levels in plasma and tumors of CRC patients, which could be caused by the smaller study cohort. However, the result is a potentially valuable reference for further research.

關鍵字

colorectal cance ； environmental contaminants ； microanalysis ； enzyme-linked immunosorbent assay

並列摘要

目標：大腸直腸癌（CRC）在惡性腫瘤中具高發生率與死亡率，台灣CRC病患急劇增加可能與環境汙染物（多環芳香烴碳氫類化合物、硝酸鹽和亞硝酸鹽類）有關。因此，本篇研究探討此類汙染物與台灣CRC的相關性。方法：配對的CRC患者血漿與腫瘤組織檢體取自高雄長庚紀念醫院組織銀行，由正修科技大學超微量研究科技中心萃取後，以酵素免疫分析法測定其中之硝酸鹽及亞硝酸鹽濃度，另以氣相層析儀串聯質譜儀進行16種多環芳香烴偵測。結果：因血漿中所含之亞硝酸鹽及多環芳香烴均未檢出，後續實驗針對硝酸鹽進一步分析。實驗結果顯示CRC病患血漿的硝酸鹽濃度與對照組無顯著差別，但腫瘤組織中的硝酸鹽含量顯著高於配對的血漿。但是，硝酸鹽濃度在配對的CRC血漿與腫瘤組織中不具顯著關聯，且不同期別CRC的血漿與腫瘤組織硝酸鹽含量也無顯著差異。結論：此較小樣本數之前驅性研究顯示血液與腫瘤中硝酸鹽含量與CRC的相關性並不顯著，但是可提供後續進一步研究的重要潛在參考依據。

並列關鍵字

大腸癌 ； 環境汙染物 ； 微量分析 ； 酵素免疫分析法

參考文獻

Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86. doi:10.1002/ijc.29210

Kuo CN, Liao YM, Kuo LN, Tsai HJ, Chang WC, Yen Y. Cancers in Taiwan: practical insight from epidemiology, treatments, biomarkers, and cost. J Formos Med Assoc 2020;119:1731-41. doi:10.1016/j.jfma.2019.08.023

Su SY, Huang JY, Jian ZH, Ho CC, Lung CC, Liaw YP. Mortality of colorectal cancer in Taiwan, 1971-2010: temporal changes and age-period-cohort analysis. Int J Colorectal Dis 2012;27:1665-72. doi:10.1007/s00384-012-1521-8

Berger BM, Schroy PC 3rd, Dinh TA. Screening for colorectal cancer using a multitarget stool DNA test: modeling the effect of the intertest interval on clinical effectiveness. Clin Colorectal Cancer 2016;15:e65-74. doi:10.1016/j.clcc.2015.12.003

Peng SM, Hsu WF, Wang YW, et al. Faecal immunochemical test after negative colonoscopy may reduce the risk of incident colorectal cancer in a population-based screening programme. Gut 2020;70:1318-24. doi:10.1136/gutjnl-2020-320761