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Influence of tumor stage, symptoms, and time of blood draw on serum concentrations of organochlorine compounds in exocrine pancreatic cancer

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Abstract

Background

Knowledge is scant on the relationships between pathophysiologic processes common during cancer progression and changes in blood concentrations of organochlorine compounds (OCs).

Objective

To analyze the influence of tumor stage, cancer symptoms, and time of blood extraction on serum concentrations of OCs in exocrine pancreatic cancer (EPC).

Methods

Subjects were 144 incident cases of EPC prospectively recruited in eastern Spain. Blood was drawn and face-to-face interviews with patients were conducted during hospital admission. Information on signs and symptoms was obtained from medical records and patient interviews. OCs were analyzed by high-resolution gas chromatography with electron-capture detection. General linear models were applied to analyze log-transformed OCs corrected for total lipids.

Results

Lower concentrations of six of the seven OCs analyzed (p,p′-DDE, three polychlorinated biphenyls, hexachlorobenzene, and β-hexachlorocyclohexane) were observed in patients with cholestatic syndrome (jaundice, hypocholia, and choluria). The constitutional syndrome increased only p,p′-DDT. The lowering effect of the cholestatic syndrome was stronger than the increasing effect of the constitutional syndrome (fatigue, anorexia, and weight loss), except for p,p′-DDT. When symptoms were considered, stage had only weakly inverse relationships with OC levels. The effects of symptoms on p,p′-DDE, p,p′-DDT, and the three PCBs remained significant after adjusting by the interval from blood extraction to first symptom of EPC, and even when further adjusting by stage.

Conclusions

Restriction or adjustment by stage and timing of blood draw may be insufficient to prevent biases associated with cancer progression. Symptoms may enable investigators to assess disease-induced changes in lipophilic exposure biomarkers.

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Abbreviations

β:

Regression coefficient

CI:

Confidence interval

p,p′-DDE:

Dichlorodiphenyldichloroethene or 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene

p,p′-DDT:

Dichlorodiphenyltrichloroethane or (bis[p-chlorophenyl]-1,1,1-trichloroethane)

EPC:

Exocrine pancreatic cancer

GLM:

General linear models

HCB:

Hexachlorobenzene

HCH:

Hexachlorocyclohexane

IES:

Interval from blood extraction (or blood draw) to first symptom of EPC

OCs:

Organochlorine compounds

PCBs:

Polychlorinated biphenyls

R 2 :

Coefficient of determination

TSL:

Total serum lipids

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Acknowledgments

Supported by research grants from Generalitat de Catalunya (CIRIT SGR 0241, SGR 0078); ‘Red temática de investigación cooperativa de centros en Cáncer’ (C03/10), ‘Red temática de investigación cooperativa de centros en Epidemiología y salud pública’ (C03/09), and CIBER de Epidemiología, Instituto de Salud Carlos III. The authors gratefully acknowledge scientific and technical assistance provided by Paco Real, Núria Malats, Montserrat Fitó, María-Isabel Covas, Elisa Puigdomènech, Magda Gasull, Marta Crous, Magda Bosch de Basea, Silvia Geeraerd, and Yolanda Rovira.

Disclosure of potential conflicts of interest

The authors declare they have no competing financial interests. The study sponsors had no role and no involvement in the study design, nor in the collection, analysis, and interpretation of data; they also had no role and no involvement in the writing of the report, nor in the decision to submit the article for publication.

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Authors and Affiliations

  1. Institut Municipal d’Investigació Mèdica (IMIM)-Hospital del Mar, Universitat Autònoma de Barcelona, Carrer del Dr. Aiguader 88, E-08003, Barcelona, Catalonia, Spain

    Miquel Porta, José Pumarega, Tomàs López & Manuel Jariod

  2. Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

    Miquel Porta

  3. CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Miquel Porta, José Pumarega & Tomàs López

  4. Universitat Rovira i Virgili, Reus, Tarragona, Spain

    Manuel Jariod

  5. Department of Environmental Chemistry, Institute of Chemical and Environmental Research (IIQAB-CSIC), Barcelona, Spain

    Esther Marco & Joan O. Grimalt

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  1. Miquel Porta
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  2. José Pumarega
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  3. Tomàs López
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  5. Esther Marco
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  6. Joan O. Grimalt
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for the PANKRAS II Study Group

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Correspondence to Miquel Porta.

Additional information

PANKRAS II Study: Multicenter Prospective Study on the Role of K-ras and other Genetic Alterations in the Diagnosis, Prognosis, and Etiology of Pancreatic and Biliary Diseases.

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Porta, M., Pumarega, J., López, T. et al. Influence of tumor stage, symptoms, and time of blood draw on serum concentrations of organochlorine compounds in exocrine pancreatic cancer. Cancer Causes Control 20, 1893–1906 (2009). https://doi.org/10.1007/s10552-009-9383-2

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