The Abnormal Aterations Of Iron Metabolism In The Primary Lung Cancer And The Prognosis Of Correlation Analysis

Objective:The aim of this study is to investigate the abnormal alterations of the serum iron, ferritin, total iron-binding capacity(TIBC) in Primary Lung Cancer(PLC). The relationship of these parameters with prognosis is also explored. Methods:105 patients with PLC were recruited from the department of respiration of the First Affiliated Hospital of Zhengzhou University. Among the 105 PLC patients, 45 patients were diagnosed with squamous cell carcinoma, 36 patients with adenocarcinoma, 5 patients with non-small cell lung cancer, and 19 patients with small cell lung cancer. Meanwhile, 87 patients with benign pulmonary diseases were recruited. The serum iron, ferritin, total iron-binding capacity(TIBC) were determined for all the patients. The PLC patients were followed up by telephone. The follow-up period was 1-36 months. The survival time was calculated from the PLC being diagnosed to death or the end of follow-up.All data with a normal distribution were presented as mean ± standard deviation(SD). For continuous variables, independent sample t-test was employed. Differences for categorical data were performed by chi-square test. The comparison for multivariables was performed by Kruskal-Wallis test and LSD-t test. The correlation of two independent variables was analyzed by Pearson correlation analysis. Analysis was performed with SPSS 15.0 software. Results:1. The serum ferritin was significantly higher in PLC group than that in benign pulmonary diseases group(p < 0.05). Compared with benign pulmonary diseases group, there was a significant reduction of TIBC in PLC group(p < 0.05). Compared with benign pulmonary diseases group, the serum iron level was decreasing in PLC group; however, there was no significant difference between the two groups(P>0.05).2. The serum ferritin was superior to TIBC in differential diagnosis of lung cancer from benign pulmonary diseases in terms of sensitivity, specificity, and precision.3. The high expression of serum ferritin in PLC patients was correlated with gender(P=0.028), smoking(P=0.014), and neoplasm staging(P=0.035); however, it is not associated with age(P=0.361), and pathological type(P=1.529).4. The serum iron was significantly different in PLC I and II stage than that in PLC Ⅲ and Ⅳ stage(p < 0.05); however, there was no significant difference between the PLC Ⅲ and Ⅳ stage(P=0.89). Meanwhile, the serum ferritin was significantly different in PLC I and II stage than that in PLC Ⅲ and Ⅳ stage(p < 0.05). Also, the serum ferritin was significantly different in PLC Ⅲ stage than that in PLC Ⅳ stage(p < 0.05).5. There was significant positive correlation between serum ferritin and maximum diameter of tumor(r=0.674, P=0.000).6. The survival rate of PLC patients in decreasing serum iron and increasing serum ferritin was 26.3% and 34.9%, respectively. The survival rate was significant lower in above patients compared with other PLC patients without the changes of serum iron and serum ferritin(p < 0.05). Conclusions:1.The serum ferritin and TIBC are of use in differential diagnosis of lung cancer from benign pulmonary diseases. Moreover, the serum ferritin is more valuable in differential diagnosis.2. The monitoring of serum iron and ferritin has important clinical value in evaluating the degree and prognosis of lung cancer patients.