Preoperative iron status is a prognosis factor for stage II and III colorectal cancer
Preoperative iron status is a prognosis factor for stage II and III colorectal cancer
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DOI：
10.1007/s10147-021-01995-9
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发表时间：
2021-07-23
影响因子：
3.3
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Sawayama, Hiroshi;Miyamoto, Yuji;Baba, Hideo
背景缺铁性贫血在结直肠癌（CRC）患者中有代表性。铁过剩负荷增加非转铁蛋白结合铁（NTBI），NTBI促进癌症进展并影响微生物群。本研究调查了术前血清铁状态是否与结直肠癌切除术后的预后相关。方法我们评估了327例II-III期结直肠癌手术患者术前铁和转铁蛋白饱和度（TSAT），计算方法为铁除以总铁结合力。Fe < 60 μ g/dl和TSAT > 40%分别被定义为低铁和高铁。采用单因素和多因素考克斯比例风险分析评价铁营养状况与总生存期（OS）之间的关系。结果327例患者中，低铁179例（54.7%），正常124例（37.9%），高铁24例（7.3%）。在单变量分析中，低铁与OS较短相关（风险比[HR] 2.821，95%置信区间[CI] 1.451-5.485，P = 0.002）。高铁还与OS较短相关（HR 3.396，95% CI 1.359-8.489，P = 0.009）。在多变量分析中，（P = 0.002），浸润深度pT 4（P = 0.012），淋巴结转移（P = 0.035），低白蛋白（P = 0.011），低铁（HR 2.282，95% CI 1.163-4.478，P = 0.016）和高铁（HR 3.757，95%CI 1.486-9.494 P = 0.005）与较短的OS独立相关。与正常铁相比，高铁与肿瘤内具核梭杆菌的数量相关。结论在单因素和多因素分析中，术前低铁和高铁均与II-III期结直肠癌患者的不良OS相关。
Background Iron deficiency anemia is represented in colorectal cancer (CRC) patients. Iron surplus load to increase non-transferrin bound iron (NTBI), and NTBI promotes cancer progression and influences microbiota. This study investigated whether preoperative serum iron status was associated with prognosis after CRC resection. Methods We evaluated preoperative iron and transferrin saturation (TSAT), which was calculated as iron divided by total iron-binding capacity, in 327 patients who underwent surgery for Stage II-III CRC. Fe < 60 mu g/dl and TSAT > 40% were defined as low and high iron, respectively. The associations between iron status and overall survival (OS) were evaluated in univariate and multivariate Cox proportional hazards analysis. Results Of the 327 patients, 179 (54.7%), 124 (37.9%) and 24 (7.3%) had low, normal and high iron, respectively. In univariate analysis, low iron was associated with shorter OS (hazard ratio [HR] 2.821, 95% confidence interval [CI] 1.451-5.485, P = 0.002). High iron was also associated with shorter OS (HR 3.396, 95% CI 1.359-8.489, P = 0.009). In multivariate analysis, high age (P = 0.002), depth of invasion pT4 (P = 0.012), lymph-node metastasis presence (P = 0.035), low albumin (P = 0.011), low iron (HR 2.282, 95% CI 1.163-4.478, P = 0.016) and high iron (HR 3.757, 95% CI 1.486-9.494 P = 0.005) were independently associated with shorter OS. High iron was associated with the amount of intratumoral Fusobacterium nucleatum compared with normal iron. Conclusion Both low and high preoperative iron in Stage II-III CRC patients were associated with unfavorable OS in univariate and multivariate analyses.