Progressive Iron Deficiency with Advancing Stage in Colorectal Cancer Patients

Yu-Yao Chang, Jeng-Kai Jiang, Shih-Ching Chang, Jen-Kou Lin, Chi-Jung Huang and Shung-Haur Yang

Department of Surgery, Taipei Veterans General Hospital, Taiwan
Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan
Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Department of Molecular Genetics and Biochemistry Laboratory, Cathay General Hospital, Taiwan

^*Correspondance to: Shung-Haur Yang 

 PDF  Full Text DOI: 10.25107/2474-1647.2218

Abstract

Aim: Iron Deficiency Anemia (IDA) is common among Colorectal Cancer (CRC) patients. This study evaluated the iron status of CRC patients as the stage of cancer progressed.Methods: We used a prospectively constructed database to retrospectively retrieve data for 435 consecutive patients who underwent elective resections. We examined correlations between cancer stage and anemia-related profiles.Results: Progressively lower hemoglobin levels correlated with more advanced cancer stage. Transferrin saturation decreased with increasing cancer stage. Ferritin levels decreased with increasing cancer stage for stages I through III, but were significantly higher in stage IV disease. Transferrin levels significantly increased from stage I to stage II, did not change in stage III, and then significantly decreased in stage IV. Among patients with stage IV disease, higher ferritin levels did not correlate with prognosis.
Conclusion: CRC patients may become more anemic, have worse nutrition, and become iron deficient with increasing cancer stage. Patients with metastatic disease had higher ferritin levels and lower transferrin. Notably, it is believed that these factors are altered by inflammation. Therefore, serum iron and transferrin saturation are more reliable markers of iron status in CRC patients than ferritin and transferrin.

Keywords

Colorectal neoplasm; Ferritin; Iron deficiency anemia; Transferrin saturation; Acute phase protein

Cite the article

Chang Y-Y, Jiang J-K, Chang S-C, Lin J-K, Huang C-J, Yang S-H. Progressive Iron Deficiency with Advancing Stage in Colorectal Cancer Patients. Clin Surg. 2018; 3: 2218.