Jacober M L V, Mamoni R L, Lima C S P, Dos Anjos B L, Grotto H Z W
Departamento de Patologia Clínica/FCM/UNICAMP, Caixa Postal 6111, Campinas, SP, Brazil.
Med Oncol. 2007;24(3):323-9. doi: 10.1007/s12032-007-0009-9.
Hepcidin has been proposed as an important factor in the pathogenesis of the anaemia of chronic disease (ACD). The aim of this study was to assess the relationship between anaemia and inflammatory activity in patients with solid tumours. Patients were classified as having iron deficiency anaemia (IDA) (hypoferremia and hypoferretinemia), ACD (hypoferremia, normal or increased serum ferritin) and anaemia related to cancer (ARC) (no abnormalities in iron status). Serum pro-hepcidin, IL-6, C-reactive protein (CRP) and iron status parameters were measured using commercial kits. CRP and IL-6 levels were significantly higher in patients with ACD when compared to IDA, ARC and non anaemic patients (P < 0.005). Serum pro-hepcidin levels were not different among all studied groups (P = 0.138). A negative correlation was observed between haemoglobin and serum ferritin, CRP and IL-6 levels only in group of ACD. Serum pro-hepcidin concentrations were not correlated with degree of anaemia or iron metabolism parameters. According to our results the inflammatory activity represented by high levels of IL-6 and CRP are involved in the pathogenesis of ACD, probably due to the action of inflammation on iron metabolism, but not in ARC. It was not possible to demonstrate a significant effect of pro-hepcidin on the anaemia in cancer patients.
铁调素已被认为是慢性病贫血（ACD）发病机制中的一个重要因素。本研究的目的是评估实体瘤患者贫血与炎症活动之间的关系。患者被分为缺铁性贫血（IDA）（低铁血症和低铁蛋白血症）、ACD（低铁血症，血清铁蛋白正常或升高）和癌症相关贫血（ARC）（铁状态无异常）。使用商用试剂盒检测血清前铁调素、白细胞介素-6（IL-6）、C反应蛋白（CRP）和铁状态参数。与IDA、ARC和非贫血患者相比，ACD患者的CRP和IL-6水平显著更高（P < 0.005）。所有研究组之间的血清前铁调素水平无差异（P = 0.138）。仅在ACD组中观察到血红蛋白与血清铁蛋白、CRP和IL-6水平呈负相关。血清前铁调素浓度与贫血程度或铁代谢参数无关。根据我们的结果，高水平的IL-6和CRP所代表的炎症活动参与了ACD的发病机制，可能是由于炎症对铁代谢的作用，但在ARC中并非如此。无法证明前铁调素对癌症患者贫血有显著影响。
