The results of the analyses, expressed in µg/L in the blood and in µg/g in the hair for the 14 metals, and in pg/mL for PCBs, and evaluated according to the reference tables of the ISTISAN (Table 3) and WHO-2005 reports, were subsequently compared with the diseases each patient was suffering from, and to patient origin. The results showed that, in the 11 patients with tumors, the levels of the 14 heavy metals in the blood were considerably higher than the permitted levels, in half of them (e.g. lead) (Fig. 1), while the levels in the hair were significantly higher than the maximum reference values in some of them. With regard to the blood levels of the 12 PCBs, some of the patients showed positive values significantly higher than the maximum reference value (although there are no clearly established reference values according to the WHO-2005 reports).
In the 9 healthy volunteers, concentrations of heavy metals in the blood were within the reference ranges; positive tested metals (≤ 3 of 14 heavy metals for each participant) were slightly higher than the maximum reference value (Figs. 2, 3). The levels of the 14 heavy metals in the hair were negative; the blood levels of the 12 PCBs were either negative or positive, with values close to the minimum reference value. The results of the tests performed on the 11 patients with tumors showed that the 2 patients with laryngeal carcinoma (a 57-year female patient with a G2–G3 squamous cell carcinoma of the vocal cords, and a 70-year male patient with a squamous cell carcinoma of the epiglottis) had similar elevated levels of the same heavy metals in the blood (Aluminum, Antimony, Arsenic, Cadmium, Chromium, Mercury, Nickel, Lead, Copper, Zinc), and of the same PCBs in the blood (2′3,4,4′,5-pentachlorobiphenyl [PeCB] [PCB-123]; 2,3′,4,4′,5-PeCB [PCB-118]; 2,3,4,4′,5-PeCB [PCB-114]); they had also similar elevated levels of Arsenic, Cadmium, Chromium and Lead in the hair. The patient suffering from non-Hodgkin’s lymphoma of the tonsil (mantle cell variety) had similar high levels in the blood as those found in the patients with laryngeal carcinoma (Aluminum, Antimony, Arsenic, Cadmium, Chromium, Mercury, Nickel, Lead, Copper), with the exception of zinc which was within the normal range, as well as high blood concentrations of the following PCBs: 2′,3,4,4′,5–2,3,4,4′5 and 2,3,3′,4,4′,5′-hexachlorobiphenyl (HxCB) (PCB-157). The levels of arsenic and chromium were the highest also in the hair. This patient also had the highest levels of aluminum, antimony, arsenic, cadmium, chromium, and nickel in the blood.
The 4 patients with thyroid carcinoma, both papillary and follicular types, had almost similar high levels of Aluminum, Cadmium, Mercury, Nickel, and Lead in the blood, as well as elevated blood levels of PCB-114; 2,3,4,4′,5.
Chromium levels were about three times higher in the hair, except in a case of papillary carcinoma where chromium values were close to the maximum permitted levels, and arsenic values were almost double. In 3 cases, we found both 2,3,4,4′,5- and 2,3′,4,4′,5-pentachlorobiphenyl in the blood.
All 3 patients with thyroid goiter had similarly high levels of Aluminum, Antimony, and Zinc in the blood; as for the PCBs, 2 patients had high blood levels of 2,3,3′,4,4′,5′-HxCB (PCB-156), and one patient had elevated blood levels of PCB-114. 2,3′,4,4′,5.
After further analysis of these findings, with patients di vided according to their place of residence, and compared with each other (Graphs 1, 2, 3, 4, 5, 6, 7, 8), we found that: in 4 patients from the area of Casoria (Na), Acerra (Na), Casalnuovo (Na), and Aversa (Na), test results showed commonly and significantly elevated levels of Aluminium, Cadmium, Mercury, zinc and lead measured in the blood; chromium was elevated in the blood in three patients from these towns, and was present in the hair of all four subjects; a patient from Giugliano (Na) showed high levels of Antimony, lead and zinc in the blood, and of Chromium and Arsenic in the hair; a patient from Marano (Na) showed high levels of Aluminum, Zinc, Cadmium, Antimony, and Chromium in the blood, and of Lead, cadmium in the hair; in 2 patients from Naples, higher values of Aluminum, Lead, Arsenic, Mercury, Antimonium, Cadmium, Nickel and Zinc in the blood, and of Chromium, Cadmium, Arsenic and Lead in the hair, were commonly reported; a patient living in Frignano (Ce) had the highest values of Aluminum, Cadmium, Arsenic, Mercury, and Lead in the blood, and of Chromium and Arsenicum in the hair; patients living in Cava de Tirreni (Sa) had higher values of Aluminum, Antimony, Arsenic, Cadmium, Chromium, Mercury, Nickel, and Lead in the blood, and of Arsenicum in the hair. The patient living in Buccaletto had elevated blood levels of aluminum, cadmium, nickel, and zinc, as well as elevated hair levels of chromium.
We did not find a clear correlation between tumor stage and the levels of metals in the blood and hair, or the levels of PCBs in the blood. Instead, we have shown above that the nasopharyngeal cancer and lymphoma of the tonsil were associated with the same heavy metals in the blood and with the same PCBs. The nasopharyngeal cancer had in the hair matrix the same metals that were present in the blood, and the lymphoma showed high levels of arsenic and chromium also in the hair matrix. Similarly, we have observed the same trend for thyroid tumors with the same metals in the blood (Aluminum, Cadmium, Mercury, Nickel, and Lead)