Association of serum copper, zinc level in invasive cervical cancer in a tertiary hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20242786Keywords:
Cervical cancer, Copper, Cu/Zn ratio, Serum trace elements, ZincAbstract
Background: Cervical cancer remains a significant global health concern. The present study was conducted to assess the relationship between serum copper and zinc levels in individuals diagnosed with cervical cancer. The aim of this study was to assess the association between serum copper and zinc levels in invasive cervical cancer in a tertiary hospital.
Methods: This case-control study was conducted among 122 women, aged 25-65, attending the outpatient department and Colposcopy Clinic of the Department of Gynecological Oncology, BSMMU, Dhaka, from April 2022 to March 2023. The cases (n=61) had histopathologically confirmed cervical cancer, while the controls (n=61) had normal cervixes. Serum copper and zinc levels were measured at the Laboratory of Biochemistry and Molecular Biology, BSMMU. Data were analyzed using Microsoft Excel and SPSS v27.0.
Results: The study revealed that cervical cancer cases had significantly higher serum copper levels and a 6.4 times higher risk when copper levels were ≥140.0 mcg/dl. Serum zinc levels were significantly lower in cases, with a 3.9 times higher risk when zinc levels were <68 mcg/dl. Additionally, the Cu/Zn ratio was higher in cases, and a ratio >1.87 conferred a 4.5 times higher risk of cervical carcinoma.
Conclusions: Elevated copper, reduced zinc, and a higher copper-zinc ratio were observed in cervical cancer patients, suggesting a potential association with cervical cancer risk and warranting further investigation for clinical applications in early detection and management.
References
Narayan S, Rose RJ. Cervical cancer detection based on novel decision tree approach. Computer Syst Sci Engin. 2023;44(2):1025-38.
Zhang M, Shi M, Zhao Y. Association between serum copper levels and cervical cancer risk: a meta-analysis. Biosc Rep. 2018;38(4):1.
Alam NE, Islam MS, Rayyan F, Ifa HN, Khabir MIU, Chowdhury K, et al. Lack of knowledge is the leading key for the growing cervical cancer incidents in Bangladesh: A population-based, cross-sectional study. PLOS Glob Public Health. 2022;2(1):1.
Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri: 2021 update. Int J Gynaecol Obstet. 2021;155 Suppl 1(S1):28-44.
Carter JR, Ding Z, Rose BR. HPV infection and cervical disease: a review: HPV and cervical disease. Aust N Z J Obstet Gynaecol. 2011;51(2):103-8.
Bayo S, Bosch FX, De Sanjosé S, Muñoz N, Combita AL, Coursaget P. Risk factors of invasive cervical cancer in Mali. Int J Epidemiol. 2002;31(1):202-9.
Atakul T, Altinkaya SO, Abas BI, Yenisey C. Serum copper and zinc levels in patients with endometrial cancer. Biol Trace Elem Res. 2020;195(1):46-54.
Wołonciej M, Milewska E, Roszkowska-Jakimiec W. Trace elements as an activator of antioxidant enzymes. Postepy Hig Med Dosw. 2016;70(0):1483-98.
Naidu MSK, Suryakar AN, Swami SC, Katkam RV, Kumbar KM. Oxidative stress and antioxidant status in cervical cancer patients. Ind J Clin Biochem. 2007;22(2):140-4.
Skrajnowska D, Bobrowska-Korczak B. Role of zinc in immune system and anti-cancer defense mechanisms. Nutrients. 2019;11(10):2273.
Sravani AB, Ghate V, Lewis S. Human papillomavirus infection, cervical cancer and the less explored role of trace elements. Biolog Trace Element Res. 2023;201(3):1026-50.
Kim SY, Kim JW, Ko YS, Koo JE, Chung HY, Lee-Kim YC. Changes in lipid peroxidation and antioxidant trace elements in serum of women with cervical intraepithelial neoplasia and invasive cancer. Nutr Cancer. 2003;47(2):126-30.
Cunzhi H, Jiexian J, Xianwen Z, Jingang G, Shumin Z, Lili D. Serum and tissue levels of six trace elements and copper/zinc ratio in patients with cervical cancer and uterine myoma. Biol Trace Elem Res. 2003;94(2):113-22.
Ji J, Liu J, Liu H, Wang Y. Comparison of serum and tissue levels of trace elements in different models of cervical cancer. Biolog Trace Element Res. 2014;159:346-50.
Thovarayi S, Noronha JA, Nayak S. Knowledge of cervical cancer screening among rural Indian women: a cross-sectional study. J Nurs Heal Sci. 2014;3(3):51-55.
Okunade KS, Dawodu OO, Salako O, Osanyin GE, Okunowo AA, Anorlu RI. Comparative analysis of serum trace element levels in women with invasive cervical cancer in Lagos, Nigeria. Pan Afr Med J. 2018;31(1):194.
Meghana G, Kalyani R, Sumathi M, Sheela S. Significance of copper, zinc, selenium and fluoride in squamous cell carcinoma of cervix-a pilot study. J Clin Diagn Res. 2019;13(5):1.
Tiwari V, Shukla P, Gupta G. Serum zinc as a prognostic indicator in locally advanced cancer cervix patients receiving chemo-irradiation: A pilot study. South Asian J Cancer. 2014;3(1):43-7.
Xie Y, Wang J, Zhao X, Zhou X, Nie X, Li C. Higher serum zinc levels may reduce the risk of cervical cancer in Asian women: a meta-analysis. J Int Medi Res. 2018;46(12):4898-906.
Ma ZY, Qiao Z, Wang DB, Hou X, Qiao X, Xie CZ. A mixed-ligand copper (II) complex that inhibits growth and induces apoptosis by DNA targeting in human epithelial cervical cancer cells. Appl Organomet Chem. 2017;31(7):1.
