Exposure to per- and polyfluoroalkyl substances in lung cancer patients and their associations with clinical health indicators

Si-Nan Huang; Ying-Hua Hu; Ting-Ting Xu; Yu-Ling Luan; Li-Xi Zeng; Zi-Feng Zhang; Ying Guo

doi:10.1016/j.envpol.2024.123995

Exposure to per- and polyfluoroalkyl substances in lung cancer patients and their associations with clinical health indicators

Environ Pollut. 2024 Apr 16:350:123995. doi: 10.1016/j.envpol.2024.123995. Online ahead of print.

Authors

Si-Nan Huang¹, Ying-Hua Hu², Ting-Ting Xu¹, Yu-Ling Luan¹, Li-Xi Zeng¹, Zi-Feng Zhang³, Ying Guo⁴

Affiliations

¹ Guangdong Provincial Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511436, China.
² International Joint Research Center for Persistent Toxic Substances, Heilongjiang Institute of Labor Hygiene and Occupational Diseases, The Second Hospital of Heilongjiang Province, Harbin, 100028, China.
³ International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin, 150090, China.
⁴ Guangdong Provincial Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511436, China. Electronic address: yingguo2004@jnu.edu.cn.

PMID: 38636840
DOI: 10.1016/j.envpol.2024.123995

Abstract

Per- and polyfluoroalkyl substances (PFASs) have potential carcinogenicity, immunotoxicity, and hepatotoxicity. Research has been conducted on PFAS exposure in people to discuss their potential health effects, excluding lung cancer. In this study, we recruited participants (n = 282) with lung cancer from Heilongjiang Province, northeast China. The PFAS concentrations were measured in their serum to fill the data gap of exposure, and relationships were explored in levels between PFASs and clinical indicators of tumor, immune and liver function. Ten PFASs were found in over 80 % of samples and their total concentrations were 5.27-152 ng/mL, with the highest level for perfluorooctanesulfonate (median: 12.4 ng/mL). Long-chain PFASs were the main congeners and their median concentration (20.5 ng/mL) was nearly three times to that of short-chain PFASs (7.61 ng/mL). Significantly higher concentrations of perfluorobutanoic acid, perfluorononanoic acid and perfluorohexanesulfonate were found in males than in females (p < 0.05). Serum levels of neuro-specific enolase were positively associated with perfluoropentanoic acid in all participants and were negatively associated with perfluorononanesulfonate in females (p < 0.05, multiple linear regression models). Exposure to PFAS mixture was significantly positively associated with the lymphocytic absolute value (difference: 0.224, 95% CI: 0.018, 0.470; p < 0.05, quantile g-computation models) and serum total bilirubin (difference: 2.177, 95% CI: 0.0335, 4.33; p < 0.05). Moreover, PFAS exposure can affect γ-glutamyl transpeptidase through several immune markers (p < 0.05, mediating test). Our results suggest that exposure to certain PFASs could interfere with clinical indicators in lung cancer patients. To our knowledge, this is the first study to detect serum PFAS occurrence and check their associations with clinical indicators in lung cancer patients.

Keywords: Immune cells; Liver functions markers; Lung cancer; PFAS exposure; Tumor markers.