Abstract 1561P
Background
Anemia and iron deficiency (ID) are common findings in cancer patients (pts), resulting in impaired physical function and fatigue. Hepcidin (HEP) and ferroportin (FPN) are known iron regulators. HEP exerts its regulatory function by binding to the iron exporter FPN. ZIP14 membrane transporter controls influx of nontransferrin-bound iron (NTBI) into cell. These iron regulators may be produced locally by the tumor. The aim of the study was to evaluate the prevalence of anemia and ID with assessment of tissue iron regulators - HEP, FPN and ZIP14.
Methods
Retrospective, single-centre analysis of 116 pts qualified for chemotherapy (ChT). Complete blood count and iron status were assessed prior to ChT. Anemia was defined as Hgb <12 g/dL, ID as transferrin saturation < 20%. immunohistochemical (IHC) staining was performed on the tissue samples. 38 pts met the inclusion criteria, had sufficient histopathological material for IHC staining. Table: 1561P
Clinical-pathological characteristics of PC pts
| Parameter | Frequency n | Percentage % |
| No of pts included | 38/ 116 | |
| Palliative/ adjuvant | 25/ 13 | 65,8/ 34,2 |
| Age median years (range) | 65 (42-88) | |
| Male/ female | 24/ 14 | 63,2/ 36,8 |
| Anemia1 | 17 | 44,7 |
| ID2 | 18 | 51,4 |
| HEP 03/14/ 25 | 7/24/ 6 | 18,9/ 64,9/ 16,2 |
| FPN 03/14/25 | 27/6/4 | 73,0/ 16,2/ 10,8 |
| ZIP14 03/14/25 | 13/9/15 | 35,1/ 24,3/ 40,5 |
| Stage I//II/III/IV | 6/16/4/12/ | 15,8/ 42,1/ 10,5/ 31,6 |
| pN6 0/1/2/N/A | 10/14/4/10 | 26,3/ 36,8/ 10,5/ 26,3 |
| Vascular invasion 0/1/N/A | 8/20/10 | 21,1/ 52,6/ 26,3 |
| Neural invasion 0/1/N/A | 1/27/10 | 2,6/ 71,1/ 26,3 |
1. anemia: Hgb <12 g/dl2. ID: Transferrin Saturation <20%3. 4. 5.: 0: weak/ 1: moderate/ 2: strong IHC expression6. pN: involved lymph nodes
Results
Anemia and ID were present in 44,7% and 51,4% of PC pts. IHC study showed moderate and strong expression for HEP and ZIP14 in 81,1% and 64,8% of pts consecutively, weak and moderate staining for FPN in 89,2%. HEP expression correlated negatively with FPN (p 0.037). HEP had a positive correlation with ZIP14 staining, but statistically not significant (p 0.064). Interestingly, HEP and FPN expression didn’t correlate with iron-related variables in serum, but ZIP14 correlated with serum hypoferremia (p 0,03). Strong HEP and ZIP14 with weak FPN IHC staining had no influence on pts survival.
Conclusions
Anemia and ID are frequently noted in PC pts. Iron status should be included in management of pts with PC. The exact role of ZIP14, beside HEP and FPN in the pathogenesis of ID in PC needs further studies. ZIP14 blockade can play a potential role as a treatment of ID in PC pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.