Hemoglobin levels correlate with interleukin-6 levels in patients with advanced untreated epithelial ovarian cancer: role of inflammation in cancer-related anemia.
Anemia occurs in more than 30% of patients with epithelial ovarian cancer before any surgery. High levels of proinflammatory cytokines and increased oxidative stress may contribute to the development of cancer-related anemia. We assessed a population of previously untreated patients with advanced epithelial ovarian cancer to evaluate whether there was a correlation between hemoglobin (Hb) and parameters of inflammation and oxidative stress, stage of disease, and performance status (PS). In 91 patients with epithelial ovarian cancer and 95 healthy women matched for age, weight, and height, levels of Hb, C-reactive protein (CRP), fibrinogen (Fbg), proinflammatory cytokines, leptin, reactive oxygen species (ROS), and antioxidant enzymes were assessed at diagnosis before treatment. The correlations between Hb, parameters of inflammation and oxidative stress, stage, and PS were evaluated. Hb levels were lower in patients with advanced epithelial ovarian cancer than in control subjects and inversely related to stage and PS. Hb negatively correlated with CRP, Fbg, interleukin 1beta (IL-1beta), IL-6, tumor necrosis factor alpha (TNFalpha), and ROS, and positively correlated with leptin and glutathione peroxidase (GPx). Multivariate regression analysis showed that stage and IL-6 were independent factors determining Hb values. This evidence suggests that anemia in epithelial ovarian cancer is common and its presence is related to stage of disease and markers of inflammation.
Macciò
Antonio
A
Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, Italy. a.maccio@tin.it
Madeddu
Clelia
C
Massa
Daniela
D
Mudu
Maria C
MC
Lusso
Maria R
MR
Gramignano
Giulia
G
Serpe
Roberto
R
Melis
Gian Benedetto
GB
Mantovani
Giovanni
G
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000209:etiology* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D004847:Epithelial Cells; D004906:Erythrocyte Count; D005260:Female; D005293:Ferritins / Q000097:blood; D005340:Fibrinogen / Q000378:metabolism; D005979:Glutathione Peroxidase / Q000097:blood; D006454:Hemoglobins; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007501:Iron / Q000097:blood; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000150:complications* / Q000276:immunology; D017382:Reactive Oxygen Species / Q000097:blood; D017701:Reticulocyte Count; D013482:Superoxide Dismutase / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015415:Biomarkers; D006454:Hemoglobins; D007375:Interleukin-1; D015850:Interleukin-6; D020738:Leptin; D017382:Reactive Oxygen Species; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase