Correlation Of Peripheral Blood Iron Metabolism-related Markers To Clinical Stage In Nasopharyngeal Carcinoma

Objective: It is known that iron metabolism is dysregulated in nasopharyngeal carcinoma(NPC).However,a meaningful assessment of the iron metabolic status in cancer patient is still under debate.This study aims to investigate the stateus of iron metabolism in peripheral blood,as well as to explore the correlation between those related serum markers and clinicopathological features of patients with NPC.Methods: The peripheral blood of 191 new NPC patients was collected before treatment,and 191 healthy subjects were used as controls.Serum hepcidin was measured by Enzyme-Linked Immunosorbent Assay.The expression of Epstein-Barr virus(EBV)DNA in plasma was determined by quantitative real-time polymerase chain reaction(q PCR).Serum iron(SI),unsaturated iron-binding capacity(UIBC),total iron-binding capacity(TIBC),soluble transferrin receptor(s TFR)and transferrin were determined quantitatively by using automatic biochemical analyzer.The level of ferritin was determined by electrochemiluminescence instrument.Red blood cell(RBC)count,hemoglobin(Hb),mean corpuscular volume(MCV)were tested by automatic hematology analyzer.T-test,Mann Whitney U test and unconditional logistic regression model were used to analyze the differences of the above iron metabolism indexes between NPC group and control group,and to evaluate the correlation between the above parameter and the clinicopathological features of NPC patients including gender,age and clinical stage.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum iron metabolism parameter in NPC.Spearman rank correlation analysis was used to evaluate the correlation among those parameter.All statistical tests were two-tailed,and a P value of <0.05 was considered to be statistically significant.Results: The mean levels of hemoglobin and RBC count in NPC group were significantly lower than those in control group(P<0.05),while not statistically difference was found in the mean MCV between the two groups(P>0.05).The median levels of SI,TIBC,transferrin,and hepcidin were significantly lower in NPC group than in control group(P<0.05).The male patients had significantly higher levels of SI and ferritin than female ones(P<0.05),but the male patient’s expression levels of s TFR and hepcidin were lower than female ones(P<0.05).Compared with T1-2classification patients,T3-4 classification patients exhibited significantly lower expression levels of SI and TIBC(P<0.05).The serum levels of ferritin and s TFR were significantly higher in patients with M1 classification than those with M0classification(P<0.05).EBV DNA load was associated with the serum levels of s TFR and hepcidin.Conclusions: NPC patients had functional iron deficiency.The degree of iron deficiency was related to the tumor burden and metastasis of NPC.EBV might be involved in the regulation of iron metabolism.