| Objective:To understand the distribution of functional iron deficiency in cancer-related anemia,to analyze the changes of serum hepcidin,interleukin-6 and membrane-bound Matriptase-2 in cancer-related anemia and the correlation among the three parameters,and to analyze the diagnostic value of serum hepcidin,interleukin-6 and membrane-bound Matriptase-2 in functional iron deficiency.Method:1.Objectives: 83 Cancer-related anemia patients diagnosed and treated in Affiliated Hospital of Chengde Medical University from September 2017 to Febuary 2019 who met the diagnostic criteria of the "consensus of Chinese experts on clinical practice of cancer-related anemia",and were excluded from anemia caused by folic acid and vitamin B12 deficiency,hemolysis,kidney disease and hemorrhage.At the same time,50 healthy adults served as normal control group,and 50 patients who met the consensus of multidisciplinary experts on diagnosis,treatment and prevention of iron deficiency anemia served as iron deficiency anemia group.2.Cancer-related anemia was grouped according to iron statusBased on the diagnosis and treatment of cancer-related anemia proposed by Thomas diagnostic flow chart,cancer-related anemia was divided into three groups: functional iron deficiency group,absolute iron deficiency group and iron replete group.3.Collecting specimens and data and establishing personal filesGeneral data of patients were collected,including name,sex,age,date of admission,primary disease and treatment plan,symptoms,physical examination,etc.Blood samples were collected,processed and frozen for all patients,and laboratory parameters of laboratory tests in laboratory were collected and recorded: erythrocyte hemoglobin concentration,reticulocyte hemoglobin content,C-reactive protein,urea nitrogen,creatinine,etc.Serum iron,folic acid,vitamin B12,ferritin and soluble transferrin receptors.4.detectionThe levels of serum hepcidin,interleukin-6 and membrane-bound Matriptase-2 were detected by enzyme-linked immunosorbent assay(ELISA).Results:1.From September 2017 to Febuary 2019,83 adult patients with cancer-related anemia were diagnosed and treated in Affiliated Hospital of Chengde Medical University,including 41 males and 42 females,aged 41-86 years,with an average age of 60 years.In the healthy control group,there were 50 cases,including 27 males and 23 females,aged 28-77 years,with an average age of 58 years.There were 50 patients in the iron deficiency anemia group,including 12 males and 38 females,aged from 18 to 73 years,with an average age of 45 years.There was no significant difference in age and sex(P > 0.05).2.The mean values of hepcidin in cancer-related anemia group,normal control group and iron deficiency anemia group detected by ELISA were(93.30±34.11)ng/mL,(80.21±18.00)ng/mL and(86.62±18.31)ng/mL,respectively,with significant difference(P<0.05).The mean values of interleukin-6 in cancer-related anemia group,normal control group and iron deficiency anemia group were(31.91±11.20)ng/mL,(18.05±6.86)ng/mL and(25.79±11.16)ng/mL,respectively,with significant difference(P< 0.05).The range of MTPS-2 in cancer-related anemia group,normal control group and iron deficiency anemia group were(10.79±2.86)ng/mL,(12.05±3.11)ng/mL and(13.37±6.80)ng/mL,respectively,with significant difference(P< 0.05).hepcidin and IL-6 in cancer-related anemia group were significantly higher than those in normal control group and iron deficiency anemia group(P<0.05).MTPS-2 in cancer-related anemia group was significantly lower than that in normal control group and iron deficiency anemia group(P< 0.05).3.According to Thomas diagnostic flow chart,cancer-related anemia was divided into three groups according to iron status: functional iron deficiency group,absolute iron deficiency group and iron replete group.The mean values of hepcidin in functional iron deficiency group,absolute iron deficiency group and iron replete group were(104.85±40.41)ng/mL,(85.49±37.40)ng/mL and(89.03±29.43)ng/mL,respectively.The average level of hepcidin in the absolute iron deficiency group was higher than that in the normal control group and the iron deficiency anemia group,with no significant difference(P> 0.05);the level of hepcidin in the functional iron deficiency group was significantly higher than that in the normal control group and the iron deficiency anemia group(P<0.05);the average level of hepcidin in the iron replete group was higher than that in the normal control group,with significant difference(P<0.05);In the three groups of blood,the level of hepcidin in functional iron deficiency group was significantly higher than that in absolute iron deficiency group and iron replete group(P<0.05).The mean values of interleukin-6 in functional iron deficiency group,absolute iron deficiency group and iron replete group were(40.37±13.32)ng/mL,(32.57±11.26)ng/mL,(30.06±8.86)ng/mL,respectively.The average of IL-6 in the absolute iron deficiency group was significantly higher than that in the normal control group and the iron deficiency anemia group(P<0.05);the average of IL-6 in the functional iron deficiency group was significantly higher than that in the normal control group and the iron deficiency anemia group(P<0.05);the average of IL-6 in the iron replete group was significantly higher than that in the normal control group and the iron deficiency anemia group(P<0.05).Interleukin-6 in iron deficiency anemia group was significantly higher than that in normal control group(P<0.05).The mean values of MTPS-2 in functional iron deficiency group,absolute iron deficiency group and iron replete group were(9.33±2.11)ng/mL,(12.99±4.80)ng/mL,(11.83±3.24)ng/mL,respectively.There was no significant difference in MTPS-2 between the absolute iron deficiency group and the iron deficiency anemia group(P>0.05);the average MTPS-2 in the functional iron deficiency group was lower than that in the normal control group and the iron deficiency anemia group(P<0.05);the average MTPS-2 in the iron replete group was not significantly different from that in the normal control group(P>0.05);and the average MTPS-2 in the iron replete group was poorer than that in the iron deficiency group(P>0.05).The MTPS-2 of functional iron deficiency group was significantly lower than that of absolute iron deficiency group and iron replete group(P<0.05).4.The correlation analysis of serum hepcidin in patients with cancer-related anemia showed that there was a positive correlation between the expression of hepcidin and IL-6(r=0.520,P<0.05).Serum hepcidin and IL-6 were positively correlated in the functional iron deficiency group(r=0.618,P<0.05).Conclusions:1.The levels of hepcidin,IL-6 and MTPS-2 in three groups of cancer-related anemia,normal control group and iron-deficiency anemia were different.The serum levels of hepcidin and IL-6 in patients with cancer-related anemia were significantly higher than those in patients with iron-deficiency anemia,and the serum levels of MTPS-2 were significantly lower.2.The levels of hepcidin,IL-6 and MTPS-2 in the functional iron deficiency group were significantly different from those in the other four groups,suggesting that these three indicators may be of diagnostic value for functional iron deficiency.3.There was no change in serum hepcidin in absolute iron deficiency group and iron deficiency anemia group.hepcidin in functional iron deficiency group was significantly higher than that in iron replete group. |
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