| Objectives To investigate the association of inflammatory cytokines and iron metabolism with anemia in patients with newly diagnosed cancer through clinical case-control study.To understand the distribution of various iron metabolism status and its influence on cancer-related anemia.To provide guidance for early intervention and treatment of iron deficiency in patients with cancer-related anemia.Methods There were a total of 176 newly diagnosed patients with cancer in the Affiliated Hospital of North China University of Science and Technology from November2020 to September 2021 enrolled into the research subjects.Male with Hb<120g/L and female with Hb<110g/L met the diagnostic standard for anemia.Among them,67 patients with anemia were included in the case group,and 109 patients without anemia were included in the control group.The general information of the enrolled patients included gender,age,underlying diseases,smoking,alcohol,tumor stage,body mass index and ADL score,and the score of KPS scale was completed.Routine laboratory test indicators(WBC,PTL,MCV,MCH,MCHC,ALB,ALT,AST,HDLC,LDLC,CHOL,TG,FIB,Hb,SI)were detected by the clinical laboratory of our hospital.The inflammatory cytokines(IL-1β,IL-6,TNF-α)and iron metabolism related serum markers(SF,TRF,s Tf R,Hepcidin,EPO)were detected by ELISA,and TIBC was detected by colorimetry.SPSS 25.0 was used for statistical analysis of the data.Univariate analysis was performed to compare clinical characteristics,routine laboratory test indicators,inflammatory cytokines,iron metabolism related indicators and iron metabolism status.Spearman correlation analysis was used to analyze the correlation between serum Hb and inflammatory cytokines,iron metabolism related indicators in the case group.The factors with regard to cancer-related anemia were analyzed by binary Logistic regression model.A P<0.05 was considered statistically significant.Results 1 As for basic characteristics: the proportion of advanced tumors(stage Ⅲ/Ⅳ)in the case group was higher and the ADL score and KPS score were lower than that in the control group,and the differences was statistically significant(P<0.05).There were no statistically significant differences in gender,age,underlying diseases,smoking,alcohol and body mass index between the two groups(P>0.05).As for routine laboratory test indicators: ALB,HDLC and CHOL values in the case group were lower but FIB values were higher than those in the control group,and the differences were statistically significant(P<0.05).2 As for serum inflammatory cytokines: IL-6(41.38±16.19pg/m L VS.34.33±11.34pg/m L)and TNF-α(30.82±12.12pg/m L VS.26.86±12.39pg/m L)levels in case group were clearly higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in serum IL-1β concentration between the two groups(P>0.05).3 As for iron metabolism-related indexes: serum SI(11.25±3.12μmol/L VS.22.52±5.22μmol/L),TSAT(21.06±6.58 VS.42.28±12.57)and TRF(2.79±0.48g/L VS.3.01±0.50g/L)in case group were lower but the serum Hepcidin(58.62±17.60ng/m L VS.35.38±11.22ng/m L),s Tf R(46.27±15.18nmol/L,VS.25.14±12.89nmol/L),EPO(35.37±16.92 m IU/m L VS.28.75±14.04 m IU/m L)levels were higher than those in control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in serum TIBC and SF concentrations between the two groups(P>0.05).As for the distribution of iron metabolism status: There was no significant difference between the two groups(P>0.05).4 As for correlation analysis of Hb value with inflammatory cytokines,iron metabolism in case group: Hb value was negatively correlated with IL-6,s Tf R,Hepcidin and EPO values(r=-0.315,-0.356,-0.468,-0.327,P<0.05).There was no significant correlation of Hb with IL-1β,TNF-α,SI,TIBC,TSAT,SF,TRF(P>0.05).5 As for multivariate analysis of the correlation between serum inflammatory cytokines,iron metabolism and anemia in patients with cancer: Iron metabolism related indicators including Hepcidin,s Tf R and TSAT were associated with cancer-related anemia(P<0.05).Inflammatory cytokines were not associated with cancerrelated anemia(P>0.05).Conclusions 1 Of the newly diagnosed patients with cancer,the significantly increased IL-6,TNF-α,Hepcidin,s Tf R and EPO but decreased SI,TSAT and TRF levels appeared in patients with anemia than those in patients without anemia.2 Iron deficiency,in particular,functional iron deficiency,is frequently occurred in all the enrolled patients.3Multivariate analysis found that level of increased Hepcidin and s Tf R and decreased TSAT were associated with the risk of cancer-related anemia.No association was found between the inflammatory cytokines and cancer-related anemia.Figure 0;Table 8;Reference 103... |
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