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WHAT'S IN THE WATER? TUMOR AND SERUM LEVELS OF PER-AND POLYFLUOROALKYL (PFAS) IN HEPATOBILIARY AND GASTROINTESTINAL MALIGNANCY
KA Kelly-Schuette, L Fomum-Mugri, J Walker, A Hoppe, C Mbanugo, N Nikroo, O Oboh, GP Wright, M Chung, MM Assifi
Spectrum Health Hospitals

Background
There has been significant controversy over the carcinogenic potential of per- and polyfluoroalkyl substances (PFAS). These compounds can be found in many industry and household items. Exposure to PFAS has been associated with several malignancies including thyroid, prostate, kidney, and testicular cancer.

Methods
A total of 37 serum and tumor samples from patients with hepatobiliary and gastrointestinal malignancy were tested for 24 analytes of PFAS. The primary objective was to compare our data to the national values for serum PFAS. The secondary objective was to determine the relationship between serum and tumor levels of PFAS.

Results
At least one PFAS analyte was found in 97.3 % (36/37) of the serum samples and 40.5% (15/37) of the tumor samples. Perfluorooctanesulfonic acid (PFOS) was the most common analyte isolated from the samples (15 tumor and 36 serum samples). The serum PFOS levels were significantly higher than the national levels (6.77 ng/mL vs. 5.20 ng/mL; p=0.038). The median concentration of PFOA in our serum samples was 2.40 ng/mL vs. the national median value of 1.67 ng/mL (p=0.028). The median concentration of PFHxS in our serum samples was 3.02 ng/mL vs. the national median value of 1.30 ng/mL (p=0.003). Patients with PFOS in tumor samples had significantly higher levels in serum when compared to tumor samples without PFOS (9.4 ng/mL vs 5.5 ng/mL; p=0.015).

Conclusion
In our study, patients with known hepatobiliary or gastrointestinal malignancies were found to have significantly higher levels of PFOS, PFOA, and PFHxS when compared to the reported national levels. Additionally, the patients with higher serum levels of PFOS also had tumor positive samples.


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