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

McSorley, S. T. , Tham, A., Steele, C. W. , Dolan, R. D. , Roxburgh, C. S.D. , Horgan, P. G. and McMillan, D. C. (2019) 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. European Journal of Surgical Oncology, 45(7), pp. 1205-1211. (doi: 10.1016/j.ejso.2019.02.027) (PMID:30850153)

Abstract

Background: Inflammation 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. Methods: Patients 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. Results: The 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). Conclusions: The presence of a host systemic inflammatory response to colorectal cancer was associated with significant perturbation of red cell measure of iron status.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Horgan, Professor Paul and McSorley, Dr Stephen and McMillan, Professor Donald and Steele, Dr Colin and Roxburgh, Professor Campbell and Dolan, Dr Ross
• Authors: McSorley, S. T., Tham, A., Steele, C. W., Dolan, R. D., Roxburgh, C. S.D., Horgan, P. G., and McMillan, D. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Journal of Surgical Oncology
• Publisher: Elsevier
• ISSN: 0748-7983
• ISSN (Online): 1532-2157
• Published Online: 27 February 2019
• Copyright Holders: Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
• First Published: First published in European Journal of Surgical Oncology 45(7):1205-1211
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher