Effect of Urinary Total Arsenic Level and Estimated Glomerular Filtration Rate on the Risk of Renal Cell Carcinoma in a Low Arsenic Exposure Area
Effect of Urinary Total Arsenic Level and Estimated Glomerular Filtration Rate on the Risk of Renal Cell Carcinoma in a Low Arsenic Exposure Area
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DOI：
10.1016/j.juro.2011.01.079
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Hsueh, Yu-Mei
中科院分区：
文献类型：
--
作者：
Huang, Chao-Yuan;Chu, Jan-Show;Hsueh, Yu-Mei
目的：我们探讨了尿总砷与肾细胞癌风险之间的关系，并研究了高血压或低估计肾小球滤过率是否会改变肾细胞癌的风险。材料和方法：该病例对照研究在2006年11月至2009年5月期间进行，共有132名肾细胞癌患者，和260名性别和年龄匹配的对照组。肾细胞癌的病理证实是通过图像引导下肾肿瘤活检或手术切除完成的。采用高效液相色谱-氢化物发生-原子吸收光谱法测定尿中无机砷、甲基胂酸和二甲基胂酸。估计肾小球滤过率计算使用的饮食在肾脏疾病Study equation.Results：尿总砷的修改是显着相关的剂量反应关系后，多变量调整的肾细胞癌的风险。低估计肾小球滤过率或高血压与肾细胞癌风险显著相关。肾小球滤过率与尿总砷呈显著负相关。尿总砷与高血压对肾细胞癌的危险性有显著的交互作用。高血压、估计肾小球滤过率低和尿总砷高的受试者的优势比最大（6.01）。趋势检验显示，随着这3个危险因素数量的增加，患肾癌的危险性沿着增加（p < 0.0001）。结论：尿总砷水平升高是患肾癌的强预测因子，肾小球滤过率或高血压与尿总砷相互作用，改变患肾癌的危险性。
Purpose: We explored the relationship between urinary total arsenic and risk of renal cell carcinoma, and investigated whether having hypertension or a low estimated glomerular filtration rate would modify the risk of renal cell carcinoma.Materials and Methods: The case-control study was conducted between November 2006 and May 2009 with 132 patients with renal cell carcinoma, and 260 sex and age matched controls from a hospital based pool. Pathological verification of renal cell carcinoma was completed by image guided biopsy or surgical resection of renal tumors. Urinary arsenic species, including inorganic arsenic, monomethylarsonic acid and dimethylarsinic acid, were determined with a high performance liquid chromatography linked hydride generator and atomic absorption spectrometry. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease Study equation.Results: Urinary total arsenic was significantly associated with renal cell carcinoma risk in a dose-response relationship after multivariate adjustment. Low estimated glomerular filtration rate or hypertension was significantly related to renal cell carcinoma risk. Estimated glomerular filtration rate was significantly negatively related with urinary total arsenic. A significant interaction was seen between the urinary total arsenic and hypertension on renal cell carcinoma risk. The greatest odds ratio (6.01) was seen in the subjects with hypertension, low estimated glomerular filtration rate and high urinary total arsenic. A trend test indicated that the risk of renal cell carcinoma increased along with the accumulating number of these 3 risk factors (p < 0.0001).Conclusions: Higher urinary total arsenic level was a strong predictor of renal cell carcinoma, and estimated glomerular filtration rate or hypertension interacts with urinary total arsenic in modifying the risk of renal cell carcinoma.