Serum Levels of Zinc and Copper in Patients with Endometrial Cancer: a Systematic Review and Meta-analysis

Abstract

Endometrial cancer (EC) is the leading gynecologic cancer in developed nations. Recent studies suggest that trace elements like zinc and copper may be involved in cancer development due to their involvement in essential biological processes. However, there is inconsistency regarding their serum levels in EC patients. This review sought to systematically analyze and quantify the differences in serum concentrations of zinc and copper between patients with EC and healthy controls through a meta-analysis. A comprehensive search in PubMed, Embase, Scopus, and Google Scholar was performed. Studies comparing serum zinc and/or copper concentrations between confirmed EC patients and healthy controls were included. The quality of the papers was appraised using Newcastle-Ottawa Scale. Synthesis of data was done using standardized mean differences (SMD) at 95% confidence intervals (CIs) employing RevMan software. Five studies, including 433 patients with EC and 448 healthy controls, were analyzed. Meta-analysis showed a substantial decrease in serum zinc concentrations in EC patients against controls (SMD, - 0.91; 95% CI, [- 1.73, - 0.08]; p = 0.03). Serum copper levels were slightly higher in EC patients (SMD, 0.27; 95% CI, [- 0.66, 1.20]), but the difference was not statistically substantial (p = 0.57). The analysis showed reduced serum zinc levels in EC patients, suggesting the potential of zinc as a biomarker. The non-significant trend of higher copper levels requires further investigation to conclusively determine copper's role in EC. Future studies should explore the mechanisms underlying trace element imbalances.

Keywords: Copper; Endometrial cancer; Meta-analysis; Systematic review; Uterine cancer; Zinc.