Quantitative data on red cell measures of iron status and their relation to the magnitude of the systemic inflammatory response and survival in patients with colorectal cancer |
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| Institution: | 1. Surgery Unit, Arnau de Vilanova University Hospital, 25198, Lleida, Spain;2. Pathology Unit, Arnau de Vilanova University Hospital, 25198, Lleida, Spain;3. Surgery Unit, Lozano Blesa University Clinical Hospital, 50009, Zaragoza, Spain;4. Endocrinology Unit, Arnau de Vilanova University Hospital, 25198, Lleida, Spain;1. MRC Clinical Trials Unit at University College London, Institute of Clinical Trials & Methodology, London WC1V 6LJ, UK;2. Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK;3. University College London Great Ormond Street Institute of Child Health, London, UK;1. Department of General Surgery, Hospital Universitario de Araba (HUA) Sede Hospital Santiago, Spain;2. Universidad Del País Vasco (UPV), Vitoria, Spain;3. Hospital San José, Vitoria, Spain;1. Institute of Endocrinology, Meir Medical Center, Kfar Saba, Israel;2. Department of Pathology, Tel Aviv Sourasky Medical Center, Israel;3. Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Israel;4. Department of Radiology, Tel Aviv Sourasky Medical Center, Israel;5. Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel;6. Israel Academic College, Ramat Gan, Tel Aviv University, Israel;7. Sackler Faculty of Medicine, Tel Aviv University, Israel |
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| Abstract: | BackgroundInflammation is recognised to be associated with perturbation of serum measures of iron status. However, the impact of colorectal cancer associated host inflammation on red cell measures of iron status has not been previously quantified.MethodsPatients undergoing elective surgery with curative intent, for colorectal cancer, at a single centre between 2008 and 2017 were included (n = 824). Blood samples taken for C-reactive protein (CRP), albumin, and full blood count (FBC) allowed patients to be grouped by modified Glasgow Prognostic Score (mGPS), and anaemia subtype (haemoglobin (Hb) M < 130 mg/L and F < 120 mg/L, with microcytic anaemia being mean corpuscular volume (MCV) < 80 f/L, and normocytic anaemia with MCV 80–100 f/L). Relationships between these groupings and red cell measures iron status including Hb, MCV, mean corpuscular haemoglobin (MCH) and red cell distribution width (RDW) were examined.ResultsThe combination of increasing T stage and increasing mGPS was associated with lower Hb, lower MCV, lower MCH, higher RDW, and higher prevalence of both microcytic and normocytic anaemia (all p < 0.001). The combination of CRP >10 mg/L and albumin <35 g/L was associated with lower Hb, lower MCV, lower MCH, higher RDW, and higher prevalence of both microcytic and normocytic anaemia (all p < 0.010). At multivariate Cox regression only Hb remained significantly associated with cancer specific (HR 0.98, 95% CI 0.97–0.99, p < 0.001), and overall survival (HR 0.98, 95% CI 0.97–0.99, p = 0.001).ConclusionsThe presence of a host systemic inflammatory response to colorectal cancer was associated with significant perturbation of red cell measure of iron status. |
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| Keywords: | Colorectal cancer Systemic inflammation Anaemia |
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