The involvement of
iron and
inflammation parameters on overall survival in
non-small-cell lung cancer (NSCLC) patients was studied. Furthermore,
transferrin receptors 1 (TfR1) and
ferritin expression in
tumor tissue,
tumor stroma, and normal lung tissue were analyzed.
Iron metabolism and
inflammation parameters were determined by automated laboratory measurements at the time of diagnosis. TfR1 and
ferritin expression were determined by immuno-histochemical methods. About 50% of patients survived 12 months only. At the time of diagnosis more than half of the patients had
anemia and significantly
elevated serum ferritin.
Iron content of serum
ferritin (ICF) was below the reference values in 90% of patients. Furthermore, ICF showed positive correlation with
iron metabolic parameters and survival but negative correlation with serum
ferritin and ESR. The expression of TfR1 and
ferritin in
tumor cells was observed in 88% or 62% of patients, respectively.
Tumor stroma was TfR1 negative and sporadically
ferritin positive.
Tumor tissue
ferritin expression showed negative correlation with serum
iron and hematokrit (Ht), and positive correlation with
ferritin, erythrocyte sedimentation rate (ESR), alpha-1
globulin, and alpha-2
globulin. Positive correlation was found between TfR1 expression in
tumor tissue and
alpha-globulin. The correlation between TfR1/
ferritin expression in
tumor tissue and ICF or survival was not observed. Therefore, we conclude that
elevated serum ferritin in sera of NSCLC patients is the result of
inflammation and oxidative stress rather than body
iron overload. Higher expression of
ferritin in
tumor tissue may be the consequence of
iron deficiency or local toxicity induced by environmental factors.