The Relationship Between Zinc Level and Pathological Response in Rectum Cancer Patients Receiving Total Neoadjuvant Therapy

Year 2024, Volume: 77 Issue: 3, 253 - 257, 10.10.2024

Efe Cem Erdat , Merih Yalçıner , Çağla Tezduyan , Güngör Utkan

Abstract

Objectives: Total neoadjuvant therapy (TNT) is used as the gold standard in rectal cancers. It is known that zinc has an effect on the cell cycle, intracellular pathways and cell proliferation. Our study was planned to investigate the relationship between zinc level and response in rectal cancer patients receiving TNT.

Materials and Methods: Information of 29 patients with rectal cancer who received TNT treatment at Ankara University Faculty of Medicine, Department of Medical Oncology was collected retrospectively and its relationship with treatment response was evaluated. Statistical analysis was performed using classical methods and Bayesian analysis.

Results: A total of 29 patients, 18 males and 11 females, were included in the study. The median age was 66 years, and histologically, 26 of the patients were found to have adenocarcinoma histology. As neoadjuvant treatment, 22 patients received short-arm radiotherapy and chemotherapy, and 7 patients received long-arm radiotherapy and chemotherapy. The median zinc level in patients with a complete response to treatment was 89 μg/dL, and in those with a partial response, the median zinc level was 77 μg/dL (p=0.07). In Bayesian analysis, the result was evaluated moderately.

Conclusion: Although a statistically significant difference was observed indicating that TNT response in rectal cancer may increase with high zinc levels, the findings are moderate according to Bayesian analysis

Keywords

Rectum cancer , neoadjuvant therapy , treatment response , zinc

Ethical Statement

Çalışma için Ankara Üniversitesi Klinik Araştırmalar Etik Kurulu (tarih: 16.11.2023, karar no.: İ10-694- 23) ve hastane başhekimliğinden onay alındı

Supporting Institution

-

Project Number

-

Thanks

-

Total Neoadjuvant Tedavi Alan Rektum Kanseri Hastalarında Çinko Düzeyi ve Patolojik Yanıt İlişkisi

Abstract

Project Number

-

References

• 1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022. CA Cancer J Clin. 2022;72:7-33.
• 2. Wan Y, Zhang B. The Impact of Zinc and Zinc Homeostasis on the Intestinal Mucosal Barrier and Intestinal Diseases. Biomolecules. 2022;12:900.
• 3. Yin JL, Tao T, Wen ZY, et al. Association between pre-diagnostic dietary copper, zinc, and copper-to-zinc ratio and severity of ovarian cancer. Front Nutr. 2022;9:1003675.
• 4. Iyer AS, Shaik MR, Raufman JP, et al. The Roles of Zinc Finger Proteins in Colorectal Cancer. Int J Mol Sci. 2023;24:10249.
• 5. Zhang ZC, Zheng LQ, Pan LJ, et al. ZNF217 is overexpressed and enhances cell migration and invasion in colorectal carcinoma. Asian Pac J Cancer Prev. 2015;16:2459-2463.
• 6. Børresen-Dale AL, Lothe RA, Meling GI, et al. TP53 and long-term prognosis in colorectal cancer: mutations in the L3 zinc-binding domain predict poor survival. Clin Cancer Res. 1998;4:203-210.
• 7. Grant WB. An ecological study of cancer mortality rates including indices for dietary iron and zinc. Anticancer Res. 2008;28:1955-1963.
• 8. Story MJ. Zinc, ω-3 polyunsaturated fatty acids and vitamin D: An essential combination for prevention and treatment of cancers. Biochimie. 2021;181:100-122.
• 9. Fong LY, Nguyen VT, Farber JL. Esophageal cancer prevention in zincdeficient rats: rapid induction of apoptosis by replenishing zinc. J Natl Cancer Inst. 2001;93:1525-1533.
• 10. Skrajnowska D, Bobrowska-Korczak B. Role of zinc in immune system and anti-cancer defense mechanisms. Nutrients. 2019;11:2273.
• 11. Hansen RD, Albieri V, Tjønneland A, et al. Effects of smoking and antioxidant micronutrients on risk of colorectal cancer. Clin Gastroenterol Hepatol. 2013;11:406-415.
• 12. Sohrabi M, Gholami A, Azar MHH, et al. Trace Element and Heavy Metal Levels in Colorectal Cancer: Comparison Between Cancerous and Noncancerous Tissues. Biol Trace Elem Res. 2018;183:1-8.
• 13. Dhawan DK, Chadha VD. Zinc: a promising agent in dietary chemoprevention of cancer. Indian J Med Res. 2010;132:676-682.
• 14. Kucharzewski M, Braziewicz J, Majewska U, et al. Selenium, Copper, and Zinc Concentrations in Intestinal Cancer Tissue and in Colon and Rectum Polyps. Biol Trace Elem Res. 2003;92:1-10.
• 15. Loh SN. The missing Zinc: P53 misfolding and cancer. Metallomics. 2010;2:442-449.
• 16. Qi J, Xing Y, Liu Y, et al. MCOLN1/TRPML1 finely controls oncogenic autophagy in cancer by mediating zinc influx. Autophagy. 2021;17:4401- 4422.
• 17. Zhang P, Xu J, Zhang H, et al. Identification of TRPV4 as a novel target in invasiveness of colorectal cancer. BMC Cancer. 2021;21:1264.