Correlation Of Serum Essential Elements Levels With The Occurrence And Malignancy Of Kidney Tumors

ObjectiveAt present,there is no clear-cut factor for kidney tumor.This study intends to start from the concentration of essential elements to explore whether there is a correlation between the content of essential elements in human serum and the occurrence and malignacy of kidney tumor,so as to make corresponding recommendations for the prevention of kidney tumor.Materials and MethodsThis study collected clinicopathological data of patients who underwent radical nephrectomy or partial nephrectomy from August 2015 to August 2017 in the Department of Urology,Shandong Province Qianfoshan Hospital,and were pathologically confirmed to have kidney tumor.The control groups were physical examiners registered in the health examination department of the same hospital.The collected data include the patient’s gender,age,height,weight,body mass index(BMI),complete blood count(CBC),liver function,kidney function,pathological results,tumor stage,tumor grade,etc.Patients who met the inclusion criteria were followed up.The start time of the follow-up was the date the patient had surgery,and the end date of the follow-up was August 31,2020.In addition,the serum of the participants were collected and the inductively coupled plasma mass spectrometry(ICP-MS)was used to determine the concentration of cobalt(Co),chromium(Cr),Copper(Cu),iron(Fe),manganese(Mn),nickel(Ni),selenium(Se),and zinc(Zn)in the subjects’ serum.The associations between the levels of each elements and risk for kidney tumor were evaluated using binary logistic regression,and correlation between a number of variables including the CBC,liver and kidney function and essential elements were assessed through Pearson’s correlation analysis using R package corrplot.The random forest model was used to evaluate the importance of each variable in terms of prediction of kidney tumor by using package randomForest.The associations between Co,Cr,Cu,Fe,Mn,Ni,Se,Zn and tumor malignancy(tumor stage and grade)were examined by Mann-Whitney U test.The Kaplan-Meier method was used to draw the progression-free survival curve,and the log-rank test was used to compare the difference in survival time.ResultsA total of 172 subjects were included in this study,including 72 healthy subjects and 100 kidney tumor patients.The median concentrations of Co(12.3 VS.17.6,P<0.001),Cr(704 VS.837,P<0.05),Fe(3975 VS.4380,P<0.05),Mn(64.1 VS.95.4,P<0.001),Ni(413 VS.527,P<0.001),Zn(953 VS.1418,P<0.001)in patients with kidney tumor were significantly lower than those in controls.In random forest model,the top three features were Co,albumin and Zn.Se level in tumor stages Ⅲ-Ⅳ were significantly lower than those in stages Ⅰ or stages Ⅱ(52.5 VS.87.6 and 97.7,P<0.05).The concentration of serum Se in tumor grades 3-4 significantly decreased compared to those in grades 1-2(65.4 VS.95.7,P<0.05).The Kaplan-Meier curve showed that patients with the lower Co and Se levels exhibited lower progression-free survival compared to patients with the higher Co and Se.ConclusionIn summary,this study gathered evidence that the disordered essential elements were associated with kidney tumor,and thus opens a new path to elucidate the etiology of kidney tumor from the perspective of environmental health and safety.