Skip to main content
Have a personal or library account? Click to login
Clinical impact of trace elements as potential biomarkers for diagnosis and prediction of response to systemic treatment in gastrointestinal cancers Cover

Clinical impact of trace elements as potential biomarkers for diagnosis and prediction of response to systemic treatment in gastrointestinal cancers

Open Access
|Apr 2026

References

  1. World Health Organization International Agency for Research on Cancer (IARC). GLOBOCAN 2020: Estimated cancer incidence, mortality and prevalence worldwide in 2020. [internet]. [cited 2026 Jan 19]. Available at: http://globocan.iarc.fr
  2. Cancer in Slovenia 2022. Ljubljana: Institute of Oncology Ljubljana, Epidemiology and Cancer Registry, Slovenian Cancer Registry; 2025.
  3. National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Colon cancer. V 2. 2025 [internet]. [cited 2026 Jan 15]. Available at: https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf
  4. Cervantes A, Adam R, Roselló S, Arnold D, Normanno N, Taïeb J, et al; ESMO Guidelines Committee. Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023; 34: 10-32. doi: 10.1016/j.annonc.2022.10.003
  5. Lowe RC, Anderson CD. Clinical presentation, diagnosis, and staging of cholangiocarcinoma. UpToDate, [internet], last updated: Sep 10, 2025. [cited 2026 Jan 15]. Available at: https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-cholangiocarcinoma
  6. Ferreira CR, Gahl WA. Disorders of metal metabolism. Transl Sci Rare Dis 2017; 2: 101-39. doi: 10.3233/TRD-170015
  7. Morales M, Xue X. Targeting iron metabolism in cancer therapy. Theranostics 2021; 11: 8412-29. doi: 10.7150/thno.59092
  8. Stojsavljević A, Vujotić L, Rovčanin B, Borković-Mitić S, Gavrović-Jankulović, Manojlović D. Assessment of trace metal alterations in the blood, cerebrospinal fluid and tissue samples of patients with malignant brain tumors. Sci Rep 2020; 10: 3816. doi: 10.1038/s41598-020-60774-0
  9. Lelièvre P, Sancey L, Coll JL, Deniaud A, Busser B. The multifaceted roles of copper in cancer: a trace metal element with dysregulated metabolism, but also a target or a bullet for therapy. Cancers 2020; 12: 3594. doi: 10.3390/cancers1212359
  10. Chen F, Han B, Meng Y, Han Y, Liu B, Zhang B, et al. Ceruloplasmin correlates with immune infiltration and serves as a prognostic biomarker in breast cancer. Aging (Albany NY) 2021; 13: 20438-67. doi: 10.18632/aging.203427
  11. Wang B, Wang XP. Does ceruloplasmin defend against neurodegenerative diseases? Curr Neuropharmacol 2019; 17: 539-49. doi: 10.2174/1570159X16666180508113025
  12. Linder MC. Ceruloplasmin and other copper binding components of blood plasma and their functions: an update. Metallomics 2016; 8: 887-905. doi: 10.1039/c6mt00103c
  13. Mukae Y, Ito H, Miyata Y, Araki K, Matsuda T, Aibara N, et al. Ceruloplasmin levels in cancer tissues and urine are significant biomarkers of pathological features and outcome in bladder cancer. Anticancer Res 2021; 41: 3815-23. doi: 10.21873/anticanres.15174
  14. Sogabe M, Kojima S, Kaya T, Tomioka A, Kaji H, Sato T, et al. Sensitive new assay system for serum wisteria floribunda agglutinin-reactive ceruloplasmin that distinguishes ovarian clear cell carcinoma from endometrioma. Anal Chem 2022; 94: 2476-84. doi: 10.1021/acs.analchem.1c04302
  15. Michalczyk K, Cymbaluk-Płoska A. The Role of zinc and copper in gynecological malignancies. Nutrients 2020; 12: 3732. doi: 10.3390/nu12123732
  16. Lossow K, Schwarz M, Kipp AP. Are trace element concentrations suitable biomarkers for the diagnosis of cancer? Redox Biol 2021; 42: 101900. doi: 10.1016/j.redox.2021.101900
  17. Chen F, Han B, Meng Y, Han Y, Liu B, Zhang B, et al. Ceruloplasmin correlates with immune infiltration and serves as a prognostic biomarker in breast cancer. Aging (Albany NY) 2021; 13: 20438-67. doi: 10.18632/aging.203427
  18. Bolann BJ, Rahil-Khazen R, Henriksen H, Isrenn R, Ulvik RJ. Evaluation of methods for trace-element determination with emphasis on their usability in the clinical routine laboratory. Scand J Clin Lab Invest 2007; 67: 353-66. doi: 10.1080/00365510601095281
  19. Balter V, Nogueira da Costa A, Bondanese VP, Jaouen K, Lamboux A, et al. Natural variations of copper and sulphur stable isotopes in blood of hepatocellular carcinoma patients. Proc Natl Acad Sci U S A 2015; 112: 982-5. doi: 10.1073/pnas.1415151112
  20. Hastuti AAMB, Costas-Rodríguez M, Matsunaga A, Ichinose T, Hagiwara S, Shimura M, et al. Cu and Zn isotope ratio variations in plasma for survival prediction in hematological malignancy cases. Sci Rep 2020; 10: 16389. doi: 10.1038/s41598-020-71764-7
  21. Lossow K, Schwarz M, Kipp AP. Are trace element concentrations suitable biomarkers for the diagnosis of cancer? Redox Biol 2021; 42: 101900. doi: 10.1016/j.redox.2021.101900
  22. Yang YW, Dai CM, Chen XH, Feng JF. The relationship between serum trace elements and oxidative stress of patients with different types of cancer. Oxid Med Cell Longev 2021; 2021: 4846951. doi: 10.1155/2021/4846951
  23. Stepien M, Jenab M, Freisling H, Becker NP, Czuban M, Tjønneland A, et al. Prediagnostic copper and zinc biomarkers and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. Carcinogenesis 2017; 38: 699-707. doi: 10.1093/carcin/bgx051
  24. Baszuk P, Marciniak W, Derkacz R, Jakubowska A, Cybulski C, Gronwald J, et al. Blood copper levels and the occurrence of colorectal cancer in poland. Biomedicines 2021; 9: 1628. doi: 10.3390/biomedicines9111628
  25. Nawi AM, Chin SF, Azhar Shah S, Jamal R. Tissue and serum trace elements concentration among colorectal patients: a systematic review of case-control studies. Iran J Public Health 2019; 48: 632-43. PMID: 31110973
  26. Lener MR, Scott RJ, Wiechowska-Kozłowska A, Serrano-Fernández P, Baszuk P, Jaworska-Bieniek K, et al. Serum concentrations of selenium and copper in patients diagnosed with pancreatic cancer. Cancer Res Treat 2016; 48: 1056-64. doi: 10.4143/crt.2015.282
  27. Yanjun Y, Jing Z, Yifei S, Gangzhao G, Chenxin Y, Qiang W, et al. Trace elements in pancreatic cancer. Cancer Med 2024; 13: e7454. doi: 10.1002/cam4.7454
  28. Türkdoğan MK, Karapinar HS, Kilicel F. Serum trace element levels of gastrointestinal cancer patients in an endemic upper gastrointestinal cancer region. J Trace Elem Med Biol 2022; 72: 126978. doi: 10.1016/j.jtemb.2022.126978
  29. Kocak OF, Yaman ME, Eroglu A. An integrated analytical approach for biomarker discovery in esophageal cancer: combining trace element and oxidative stress profiling with machine learning. J Trace Elem Med Biol 2025; 89: 127678. doi: 10.1016/j.jtemb.2025.127678
  30. Yan J, Zhang H, Zhang M, Tian M, Nie G, Xie D, et al. The association between trace metals in both cancerous and noncancerous tissues with the risk of liver and gastric cancer progression in northwest China. J Pharm Biomed Anal 2024; 242: 116011. doi: 10.1016/j.jpba.2024.116011
  31. Gupta SK, Singh SP, Shukla VK. Copper, zinc, and Cu/Zn ratio in carcinoma of the gallbladder. J Surg Oncol 2005; 91: 204-8. doi: 10.1002/jso.20306
  32. Basu S, Singh MK, Singh TB, Bhartiya SK, Singh SP, Shukla VK. Heavy and trace metals in carcinoma of the gallbladder. World J Surg 2013; 37: 2641-6. doi: 10.1007/s00268-013-2164-9
  33. Stepien M, Hughes DJ, Hybsier S, Bamia C, Tjønneland A, Overvad K, et al. Circulating copper and zinc levels and risk of hepatobiliary cancers in Europeans. Br J Cancer 2017; 116: 688-96. doi: 10.1038/bjc.2017.1
  34. Rebersek M, Hribernik N, Markovic K, Markovic S, Valentinuzzi KU, Cemazar M, et al. Determination of copper and other trace elements in serum samples from patients with biliary tract cancers: prospective noninterventional nonrandomized clinical study protocol. Radiol Oncol 2024; 58: 300-10. doi: 10.2478/raon-2024-0026
  35. Kozlica K, Milačič Ščančar R, Reberšek M, Čemažar, M, Uršič Valenzinuzzi K, Ščančar J. Advances in copper speciation, isotopic ratio measurement, bioimaging, and single-cell analysis – a critical review. TrAC trends in analytical chemistry 2025; 184: 1-24. doi: 10.1016/j.trac.2025.118152
DOI: https://doi.org/10.2478/raon-2026-0023 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Submitted on: Jan 22, 2026
Accepted on: Apr 13, 2026
Published on: Apr 16, 2026
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Martina Rebersek, Radmila Milacic Scancar, Janez Scancar, Nezka Hribernik, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.