Absolute and Functional Iron Deficiency in Colon Cancer: A Cohort Study

Abstract

Background and Objectives: Iron is an essential micronutrient for many biological functions and has been found to be intimately linked to cancer biology. Although the effects of increased dietary iron consumption in the development of CRC have been previously investigated in several cohort studies, the available evidence on the involvement of iron deficiency in this process is relatively scarce. Previously published papers did not analyze specific outcomes, such as the presence of biologically aggressive histopathological characteristics, that are associated with the subtypes of iron deficiency. The purpose of this study was to investigate the connection between the development of colorectal cancer and the presence of functional iron deficiency (FID), which is defined as insufficient biological availability of iron in the presence of adequate storage reserves, or absolute iron deficiency (AID), which is defined as severely depleted iron storage levels. Materials and Methods: Our paper represents a single center registry-based cohort study. Iron levels were routinely evaluated upon diagnosis of CRC and the collected data were coupled with patient- and tumor-specific data (2018–2022). Spearman’s correlation coefficient and the chi-squared test were used to analyze the association. Results: Out of 129 patients, 75 (58.13%) were anemic. AID was identified in 26.35% of cases and FID was encountered in 51.16% of cases. A statistically significant association between FID and lymphatic invasion was encountered. An analysis of the correlation demonstrated a significant association between anemia and right-sided tumor location. Conclusions: Functional iron deficiency seems to be independently associated with lymphatic invasion. Although a statistically significant correlation with the T or N stage was not demonstrated, the analysis suggested a potential positive relationship between the presence of FID and more aggressive tumor characteristics.

Iron Metabolism in the Recovery Phase of Critical Illness

“…FID without anemia is also common in critical illness. FID, measured by red cell hypochromasia on flow cytometry and presence of zinc protoporphyrin, represents an insufficient biological availability of iron in the presence of adequate storage reserves [14,15]. In a prospective observational study, it was reported that the incidence of FID reached up to 35% in patients at admission [4].…”

Advances in Cancer Therapy from Research to Clinical Practice—Surgical, Molecular or Systemic Management of Cancer

“…An absolute iron deficiency in colorectal cancer can impair not only the cardiac and respiratory functions, among others, but also the immune system’s defence. Deficient patients could be affected more and could present with more advanced disease–lymphatic invasion, as shown by Fagarasan et al [ 12 ].…”