KEAP1 and neoplasm: First, lead increases reactive oxygen species (ROS) levels by reducing the activity of antioxidant enzymes and activating the Nrf2/Keap1 signaling pathway, leading to cellular oxidative stress and DNA damage22-25; Secondly, lead inhibits DNA repair and alters protein structures, resulting in uncontrolled cell growth and disrupted cell signal transduction26,27; Furthermore, lead can induce the production of interleukin-8 (IL-8), promoting tumor angiogenesis and invasion28,29, and cause imbalances in oncogenes and tumor suppressor genes by altering DNA methylation levels30,31.