Changes in serum iron, total iron binding capacity and transferrin saturation percent in Sudanese females newly diagnosed with breast cancer at Khartoum Oncology Hospital: a case - control study
Keywords:
Iron profile, serum iron, TIBC, Transferrin saturation percent, breast cancer, Modified Bloom Richardson’s grading system, Sudan
Abstract
Background: Iron is a vital constituent of cells but in excess may be harmful and is associated with a raised risk for some malignant diseases including breast cancer. We aimed to study changes in iron profile in Sudanese females newly diagnosed with breast cancer.
Methods: A case- control study in which serum iron, Total Iron Binding Capacity (TIBC), and transferrin saturation percent were measured for fifty females with breast cancer referred to Khartoum Oncology Hospital and seventy apparently healthy females, using manual method (IRON-FERROZINE).
Results: Mean age was 47 years and 42 years in cases and control, respectively and the mean of parity was 4 in both groups. Mean of serum iron ±SD in case group was 244.30 ± 151.598(????g/dL) and in control group was 57.59 ± 43.191(????g/dL) (P. value = 0.000). Mean of TIBC ±SD in cases was 412.98 ± 177.460(????g/dL) and in controls it was 403.71 ± 168.765(????g/dL) (P. value = 0.838). The mean of transferrin saturation percent ± SD in cases was 61.08 % ±41.523 and in controls was 223.23 % ±149.195 (P. value=0.000). The mean of TIBC in grade I 343.00(????g/dL), 467.10(????g/dL) in grade II and 321.25(????g/dL) in grade III (P. value 0.019) according to Modified Bloom Richardson’s grading system.
Conclusion: There is a statistically significant increase in the mean of serum iron and decrease in transferrin saturation percent in women with breast cancer. TIBC vary significantly according to histopathological grade. Serum iron and transferrin saturation percent may be helpful as biochemical risk markers for breast cancer and TIBC may act as a predictor of disease grade.
References
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[34] R. Dhankhar, A. C, K. Dahiya, V. S. Ghalaut, A. K. Dhull, and A. Khurana, “Role of Iron Metabolism in Breast Cancer Patients,” Cancers Review, vol. 1, no. 2, pp. 45–51, 2014.
[2] I. E. Saeed, H.-Y. Weng, K. H. Mohamed, and S. I. Mohammed, “Cancer incidence in Khartoum, Sudan: First results from the Cancer Registry, 2009-2010,” Cancer Medicine, vol. 3, no. 4, pp. 1075–1084, 2014.
[3] BF. Rodak, GA. Fritsma, and E. Keohane, Hematology, clinical principles and applications, ISBN 0323292690, Elsevier Health Sciences, 2013.
[4] D. Ćujić, I. Stefanoska, and S. Golubović, “Serum Ferritin in Healthy Women and Breast Cancer Patients,” Journal of Medical Biochemistry, vol. 30, no. 1, 2011.
[5] J. G. Liehr and J. Shawn Jones, “Role of iron in estrogen-induced cancer,” Current Medicinal Chemistry, vol. 8, no. 7, pp. 839–849, 2001.
[6] T. Yamane, Statistics, an introductory analysis-3, http://www.worldcat.org/title/statistics-an-introductory-analysis/oclc/39121222.
[7] Barbara J. B., Dacie and Lewis Practical Haematology. 12th ed. China: Elsevier; 2017. ISBN 978-0-7020-6696-2.
[8] E. A. Stiene-Martin, C. A. Lotspeich-Steininger, and J. A. Koepke, Clinical hematology: principles, procedures, correlations, Lippincott Williams & Wilkins, 1998.
[9] R. L. Elliott and J. F. Head, “Cancer: Tumor Iron Metabolism, Mitochondrial Dysfunction and Tumor Immunosuppression; “A Tight Partnership—Was Warburg Correct?”,” Journal of Cancer Therapy, vol. 03, no. 04, pp. 278–311, 2012.
[10] R. L. Elliott, M. C. Elliott, F. Wang, and J. F. Head, “Breast Carcinoma and the Role of Iron Metabolism,” Annals of the New York Academy of Sciences, vol. 698, no. 1, pp. 159–166, 1993.
[11] P.-J. Lamy, A. Durigova, and W. Jacot, “Iron homeostasis and anemia markers in early breast cancer iron and breast cancer.,” Clinica Chimica Acta, vol. 434, pp. 34–40, 2014.
[12] O. Marques, B. M. da Silva, G. Porto, and C. Lopes, “Iron homeostasis in breast cancer,” Cancer Letters, vol. 347, no. 1, pp. 1–14, 2014.
[13] D. R. Richardson, “The iron metabolism of neoplastic cells: Alterations that facilitate proliferation?” Critical Reviews in Oncology/Hematology, vol. 42, no. 1, pp. 65–78, 2002.
[14] M. W. Hentze, M. U. Muckenthaler, B. Galy, and C. Camaschella, “Two to tango: regulation of mammalian iron metabolism,” Cell, vol. 142, no. 1, pp. 24–38, 2010.
[15] F. Wang, R. L. Elliott, and J. F. Head, “Inhibitory effect of deferoxamine mesylate and low iron diet on the 13762NF rat mammary adenocarcinoma,” Anticancer Res, Article ID 10226580, pp. 445–50, 1999.
[16] X. P. Jiang, F. Wang, D. C. Yang, R. L. Elliott, and J. F. Head, “Induction of apoptosis by iron depletion in the human breast cancer MCF-7 cell line and the 13762NF rat mammary adenocarcinoma in vivo,” Anticancer research, vol. 22, no. 5, pp. 2685– 2692, 2001.
[17] J. Blatt, Taylor Sr., and S. Stitely, “Mechanism of antineuroblastoma activity of deferoxamine in vitro,” The Journal of laboratory and clinical medicine, vol. 112, no. 4, Article ID 2459279, pp. 433–436, 1988.
[18] E. M. Hoke, C. A. Maylock, and E. Shacter, “Desferal inhibits breast tumor growth and does not interfere with the tumoricidal activity of doxorubicin,” Free radical biology medicine, vol. 39, no. 3, Article ID 15993339, pp. 403–11, 2005.
[19] S. Zhang, Y. Chen, W. Guo et al., “Disordered hepcidin-ferroportin signaling promotes breast cancer growth,” Cellular Signalling, vol. 26, no. 11, pp. 2539–2550, 2014.
[20] Z. K. Pinnix, L. D. Miller, W. Wang et al., “Ferroportin and iron regulation in breast cancer progression and prognosis,” Science Translational Medicine, vol. 2, no. 43, Article ID 43ra56, 2010.
[21] C. K. Pusatcioglu, E. Nemeth, G. Fantuzzi, X. Llor, S. Freels, L. Tussing-Humphreys et al., “Systemic and tumor level iron regulation in men with colorectal cancer: a case control study. Nutrition & Metabolism. 2014;11:21”.
[22] G. Güner, G. Kirkali (Bilgin), Ç. Yenisey, and İ. Töre, “Cytosol and serum ferritin in breast carcinoma,” Cancer Letters, vol. 67, no. 2-3, pp. 103–112, 1992.
[23] P. S. Patil, K. M. Mohandas, S. J. Bhatia, and S. A. Mehta, “Serum ferritin and the risk of hepatocellular carcinoma in chronic liver disease of viral etiology: A case-control study,” Indian Journal of Gastroenterology, vol. 33, no. 1, pp. 12–18, 2014.
[24] A. Fonseca-Nunes, P. Jakszyn, and A. Agudo, “Iron and cancer risk–a systematic review and meta-analysis of the epidemiological evidence. Cancer epidemiology, biomarkers prevention : a publication of the American Association for Cancer Research,” cosponsored by the American Society of Preventive Oncology, vol. 23, no. 1, Article ID 24243555, pp. 12–31, 2014.
[25] A. Gunel-Ozcan, S. Alyilmaz-Bekmez, E. N. Guler, and D. Guc, “HFE H63D mutation frequency shows an increase in Turkish women with breast cancer,” BMC Cancer, vol. 6, article no. 37, 2006.
[26] T. V. Kondrashova, K. Neriishi, S. Ban et al., “Frequency of hemochromatosis gene (HFE) mutations in Russian healthy women and patients with estrogen-dependent cancers,” Biochimica et Biophysica Acta - Molecular Basis of Disease, vol. 1762, no. 1, pp. 59–65, 2006.
[27] R. E. Graff, E. Cho, S. Lindstrcom, P. Kraft, W. C. Willett, and A. H. Eliassen, “Premenopausal plasma ferritin levels, HFE polymorphisms, and risk of breast cancer in the nurses’ health study II,” Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 3, pp. 516–524, 2014.
[28] N. A. Higgy, A. M. Salicioni, I. H. Russo, P. L. Zhang, and J. Russo, “Differential expression of human ferritin H chain gene in immortal human breast epithelial MCF- 10F cells,” Molecular Carcinogenesis, vol. 20, no. 4, pp. 332–339, 1997.
[29] S. I. Shpyleva, V. P. Tryndyak, O. Kovalchuk et al., “Role of ferritin alterations in human breast cancer cells,” Breast Cancer Research and Treatment, vol. 126, no. 1, pp. 63–71, 2011.
[30] W. Wang, Z. Deng, H. Hatcher et al., “IRP2 regulates breast tumor growth,” Cancer Research, vol. 74, no. 2, pp. 497–507, 2014.
[31] J. D. Yager, “Molecular Mechanisms of Estrogen Carcinogenesis,” Annual Review ofPharmacology and Toxicology, vol. 36, no. 1, pp. 203–232.
[32] D. M. Wrighting and N. C. Andrews, “Interleukin-6 induces hepcidin expression through STAT3,” Blood, vol. 108, no. 9, pp. 3204–3209, 2006.
[33] V. Pavithra, T. G. Sathisha, K. Kasturi, D. Siva Mallika, S. Jeevan Amos, and S. Ragunatha, “Serum levels of metal ions in female patients with breast cancer,” Journal of Clinical and Diagnostic Research, vol. 9, no. 1, pp. BC25–BC27, 2015.
[34] R. Dhankhar, A. C, K. Dahiya, V. S. Ghalaut, A. K. Dhull, and A. Khurana, “Role of Iron Metabolism in Breast Cancer Patients,” Cancers Review, vol. 1, no. 2, pp. 45–51, 2014.
