Hepatocellular Carcinoma in Relation to Occupational and Environmental Heavy metals Exposure

Hepatitis C and B were considered the unique risk factors encountered for HCC. However epidemiological studies indicate that human liver is susceptible also to environmental carcinogens including heavy metals. In the current study lead and cadmium were examined to find the possible relation to either chronic hepatitis or hepatocellular carcinoma because those two heavy metals are widely distributed in the Egyptian community especially in rural community. Variety of pesticides, fertilizers in addition to drinking water contamination together with smoking were considered sources of different chemicals especially those two heavy metals. Objectives: To determine the possible relation between blood lead and cadmium and HCC and chronic hepatitis. Methodology: Three groups were included 50 HCC, 50 chronic hepatitis were compared to 50 matched control group. All subjects were asked to fill an interview questionnaire that covers detailed sociodemographic, occupational and environmental risk factors . Gas chromatography was used for measurement of blood heavy metals in whole blood sample. Results: blood cadmium level was higher among HCC group compared to chronic hepatitis group and controls (1.6+0.4, 1.2+0.3 and 1+0.4) respectively with a statistically significant difference (p0.01). No statistically significant difference has been the studied groups as regard blood lead level (14.8+5, 12.5+3.4 and 12+4.7 respectively p =0.21NS). ALT and AST were higher among HCC and chronic hepatitis group compared to controls (96+43, 76+55 and 23+5) and (78+40, 70+50.7 and 16.8+5 respectively p<0.001HS). Cadmium level was inversely correlated with albumin level (r=-0.30 and p=0.02). Cadmium is positively correlated versus age r=0.32 and p=0.02S. On the other hand no statistically significant correlation could be detected between cadmium with. Lead was positively correlated versus age (r=-0.29 and p=0.04S). On the other hand no statistically significant correlation could be detected between lead and other variables (p>0.05). No statistically significant difference between males and females as regard lead and cadmium. Conclusion: This study reinforces that blood cadmium may play a role in HCC but direct effect couldn’t be confirmed. Smoking represents the main environmental source of cadmium among HCC patients. Further studies are needed to clarify direct effects of environmental risk factors in the pathogenesis and progression of liver cancer.