Hepcidin and ferritin blood level as noninvasive tools for predicting breast cancer

Abstract

Background: Currently used CA15-3 and CEA have found their clinical application particularly in the follow-up of patients with advanced disease. Novel biomarkers are urgent, especially for improving early diagnosis as well as for discriminating between benign and malignant disease. Patients and methods:In the present study, we used a proteomic approach based on surface-enhanced laser desorption/ionization-time of flight-mass spectrometry screening with the aim of identifying differentially expressed 2-30 kDa proteins in plasma of patients with malignant (65 cases) and benign (88 cases) breast lesions with respect to 121 healthy controls.Results: We found that the most promising SELDI peaks were those corresponding to hepcidin-25 and ferritin light chain. We evaluated the capability of these peaks in predicting malignant and benign breast lesions using the area under the receiver operating characteristic curve (AUC). The results showed a good capacity to predict malignant breast lesions for hepcidin-25 [AUC: 0.82; 95% confidence interval (CI) 0.75-0.90] and ferritin light chain (AUC: 0.86; 95% CI 0.79-0.92). Conversely, a weak and satisfactory capability to predict benign breast lesion was observed for hepcidin-25 (AUC: 0.63; 95% CI 0.41-0.85) and ferritin light chain (AUC: 0.73; 95% CI 0.49-0.97). A significant association between HER2 status and hepcidin-25 was observed and the distribution of transferrin and ferritin were found significantly different in patients with breast cancer when compared with that of controls. Conclusions:This study provides evidence that hepcidin and ferritin light chain level in plasma may be of clinical usefulness to predict malignant and benign disease with respect to healthy controls.

Expression of Iron-Related Proteins Differentiate Non-Cancerous and Cancerous Breast Tumors

“…This, in our study, is not accompanied by a higher expression of IL-6 and EPO making more complicated the determination of interplay between mediators of iron homeostasis, inflammation, and erythropoiesis. This results are coherent with our previous ones supporting the lack of a relationship between the plasma levels of hepcidin and both IL-6 and EPO [6]. …”

“…We have observed that hepcidin and ferritin light chain levels in plasma may predict malignant and benign disease with respect to healthy controls [6]. These findings corroborate the concept that altered systemic homeostasis is a typical feature of breast cancer patients.…”

“…Hepcidin levels in plasma of breast cancer patients are increased and these increases were not observed in non-cancerous breast conditions [6]. …”

“…Hepcidin exerts an iron homeostatic control inducing iron sequestration in macrophages and the resulting stimulation of ferritin synthesis virtually explains the high serum ferritin observed in inflammation and in some types of cancers, and the high correlation between serum hepcidin and ferritin levels have been recently reported [6]. Serum ferritin has been associated with breast cancer risk and recurrence [7,8].…”

Serum ferritin in combination with prostate-specific antigen improves predictive accuracy for prostate cancer

“…Increased levels of circulating ferritin, the body's primary iron storage protein, have been reported in a wide range of malignancies [13–16, 26–28]; moreover, increased ferritin levels are often related to decreased survival time and more aggressive disease progression [29]. For example, increased serum ferritin levels have been associated with the incidence, development, and metastasis of primary lung cancer [14].…”