Hepcidin as a Diagnostic Biomarker in Anaemic Lung Cancer Patients

SIMPLE SUMMARY: Lung cancer is the leading cause of cancer-related deaths, with a low overall survival rate. Anaemia is one of the most common cancer side effects, reducing the patient’s survival time among other things. Lung cancer patients have the highest incidence of anaemia, with 50–70% of patients experiencing anaemia during the course of their disease. In clinical practice, however, anaemia is not a problem in cancer patients until it becomes severe or life-threatening, at which point therapeutic actions are taken. We choose to change this perception by first investigating the characteristics of proteins involved in the pathogenesis of anaemia, as well as their diagnostic capabilities. We assume that predicting anaemia using diagnostic biomarkers, and thus preventing and treating anaemia in lung cancer patients, is beneficial to both the patient and the economy. ABSTRACT: We aim to describe the characteristics of hepcidin, IL-6, and TNF-α levels in anaemia of lung cancer patients with operative tumour as well as to investigate the potential diagnostic capabilities of hepcidin in combination with IL-6, TNF-α, and acute phase proteins. We present a retrospective study of 112 lung cancer patients (41 women and 71 men) who were surgically treated at the Lower Silesian Centre for Lung Diseases in Wroclaw, Poland. Serum blood samples were collected from all these patients prior to any surgical treatment and used to determine hepcidin, IL-6, TNF-α, SAA(1), and CRP concentrations. Patients were also examined with a complete blood count several times during their hospitalization. The female and male groups were divided based on the occurrence of anaemia during their hospitalization. Patients who developed anaemia post-operatively had significantly lower hepcidin concentrations than non-anaemic patients (p = 0.000694 in females with ≥3 complete blood count examinations and p = 0.007905 in males with 2 complete blood count examinations), whereas patients with anaemia since hospital admission had higher hepcidin concentrations. We observed two hepcidin roles related to two cancer anaemia pathogeneses: (1) higher hepcidin concentrations in patients with anaemia since hospital admission (anaemia of inflammation) and (2) lower hepcidin concentrations in patients who developed anaemia after surgery (anaemia of iron deficiency). Our data support the role of hepcidin, IL-6, and TNF-α in cancer-related anaemia and provide diagnostic values for predicting post-operative anaemia in lung cancer patients.