Association of the pretreatment serum ferritin concentration with prognosis in lung cancer patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANG Yifan ¹ , JIN Jian ¹ , LI Aijian ¹ , ZHANG Yan ¹ , SONG Bo ¹ , CHE Guowei ²

1. Department of Thoracic Surgery, Affiliated Hospital of Chengdu University, Chengdu 610081, P.R.China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

WANG Yifan, Email: 8582603@qq.com

Keywords：

Serum ferritin; Lung cancer; Prognosis; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.202003022

Video：

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Objectives To systematically review the association between pretreatment serum ferritin (SF) concentration and prognosis in lung cancer patients.Methods Databases including PubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data were electronically searched to identify cohort studies on the relationship between the pretreatment SF concentration and prognosis of lung cancer patients from inception to January, 2020. Literature screening, data extraction and quality evaluation of included studies were independently performed by two reviewers. Then, meta-analysis was conducted by Stata 12.0 software.Results A total of 8 cohort studies involving 1 002 lung cancer patients were included. The results of meta-analysis indicated that patients with higher pretreatment SF concentration had poorer overall survival (HR=1.70, 95%CI 1.06 to 2.73, P=0.029) compared with patients with lower pretreatment SF concentration. Subgroup analysis based on the pathological type manifested showed that pretreatment SF concentration only had high prognostic value in small cell lung cancer patients (HR=4.78, 95%CI 2.83 to 8.05, P<0.001).Conclusions Lung cancer patients with high pretreatment SF level have worse overall survival. Pretreatment SF concentration may serve as an independent prognostic factor in lung cancer, especially in small cell lung cancer. Due to the limited quality and quantity of included studies, more prospective well-designed studies are required to verify above conclusions.

Citation： WANG Yifan, JIN Jian, LI Aijian, ZHANG Yan, SONG Bo, CHE Guowei. Association of the pretreatment serum ferritin concentration with prognosis in lung cancer patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 945-949. doi: 10.7507/1672-2531.202003022 Copy

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3.	Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin, 2016, 66(4): 271-289.
4.	Planchard D, Popat S, Kerr K, et al. Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2018, 29(Suppl 4): iv192-iv237.
5.	Wang Y, Li Y, Chen P, et al. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med, 2019, 7(18): 433.
6.	Wang Y, Huang D, Xu WY, et al. Prognostic value of pretreatment lymphocyte-to-monocyte ratio in non-small cell lung cancer: a meta-analysis. Oncol Res Treat, 2019, 42(10): 523-531.
7.	Wang Y, Li S, Hu X, et al. The prognostic value of serum albumin-globulin ratio in early-stage non-small cell lung cancer: a retrospective study. Cancer Manag Res, 2019, 11: 3545-3554.
8.	王彦, 吴砚铭, 王彦文, 等. C 反应蛋白/白蛋白比值与肺癌患者预后关系的meta分析. 华西医学, 2019, 34(1): 50-57.
9.	Wang W, Knovich MA, Coffman LG, et al. Serum ferritin: past, present and future. Biochim Biophys Acta, 2010, 1800(8): 760-769.
10.	Alkhateeb AA, Connor JR. The significance of ferritin in cancer: anti-oxidation, inflammation and tumorigenesis. Biochim Biophys Acta, 2013, 1836(2): 245-254.
11.	Milman N, Sengeløv H, Dombernowsky P. Iron status markers in patients with small cell carcinoma of the lung. Relation to survival. Br J Cancer, 1991, 64(5): 895-898.
12.	Ferrigno D, Buccheri G. A comprehensive evaluation of serum ferritin levels in lung cancer patients. Lung Cancer, 1992, 8(2): 85-94.
13.	Milman N, Pedersen LM. The serum ferritin concentration is a significant prognostic indicator of survival in primary lung cancer. Oncol Rep, 2002, 9(1): 193-198.
14.	Erbaycu AE, Uçar H, Uslu O, et al. Prognostic significance of serum iron, iron-binding capacity, ferritin and bronchoalveolar lavage ferritin levels in primary lung cancer. UHOD-Uluslar Hematol, 2008, 18(4): 217-225.
15.	赵伟庆, 石红兵, 吴昌平, 等. 血清铁蛋白的表达与晚期肺癌患者预后的关系. 江苏医药, 2014, 40(24): 2978-2980.
16.	谢锦华, 吉浩明, 陈国栋, 等. 小细胞肺癌患者血清铁蛋白, 红细胞沉降率和红细胞平均指数水平与预后的关系. 国际肿瘤学杂志, 2018, 45(8): 465-469.
17.	Ma C, Zuo W. Preoperative serum bilirubin levels associated with stage and prognosis in patients with stages I-III of non-small cell lung cancer in Jiangxi province, China. Int J Clin Exp Med, 2019, 12(8): 10433-10442.
18.	Lee S, Jeon H, Shim B. Prognostic value of ferritin-to-hemoglobin ratio in patients with advanced non-small-cell lung cancer. J Cancer, 2019, 10(7): 1717-1725.
19.	Wells G, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric, 2014, 18(6): 727-734.
20.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
21.	Kuvibidila SR, Gauthier T, Rayford W. Serum ferritin levels and transferrin saturation in men with prostate cancer. J Natl Med Assoc, 2004, 96(5): 641-649.
22.	Lorenzi M, Lorenzi B, Vernillo R. Serum ferritin in colorectal cancer patients and its prognostic evaluation. Int J Biol Markers, 2006, 21(4): 235-241.
23.	Singh KJ, Singh SK, Suri A, et al. Serum ferritin in renal cell carcinoma: effect of tumor size, volume grade, and stage. Indian J Cancer, 2005, 42(4): 197-200.
24.	Ashourpour M, Djalali M, Djazayery A, et al. Relationship between serum ferritin and inflammatory biomarkers with insulin resistance in a Persian population with type 2 diabetes and healthy people. Int J Food Sci Nutr, 2010, 61(3): 316-323.
25.	王彦, 林琳, 戢艳丽, 等. 术前红细胞分布宽度与食管癌患者预后关系的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2019, 26(12): 1247-1251.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin, 2017, 67(1): 7-30.
2. Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2017: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin, 2017, 67(2): 100-121.
3. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin, 2016, 66(4): 271-289.
4. Planchard D, Popat S, Kerr K, et al. Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2018, 29(Suppl 4): iv192-iv237.
5. Wang Y, Li Y, Chen P, et al. Prognostic value of the pretreatment systemic immune-inflammation index (SII) in patients with non-small cell lung cancer: a meta-analysis. Ann Transl Med, 2019, 7(18): 433.
6. Wang Y, Huang D, Xu WY, et al. Prognostic value of pretreatment lymphocyte-to-monocyte ratio in non-small cell lung cancer: a meta-analysis. Oncol Res Treat, 2019, 42(10): 523-531.
7. Wang Y, Li S, Hu X, et al. The prognostic value of serum albumin-globulin ratio in early-stage non-small cell lung cancer: a retrospective study. Cancer Manag Res, 2019, 11: 3545-3554.
8. 王彦, 吴砚铭, 王彦文, 等. C 反应蛋白/白蛋白比值与肺癌患者预后关系的meta分析. 华西医学, 2019, 34(1): 50-57.
9. Wang W, Knovich MA, Coffman LG, et al. Serum ferritin: past, present and future. Biochim Biophys Acta, 2010, 1800(8): 760-769.
10. Alkhateeb AA, Connor JR. The significance of ferritin in cancer: anti-oxidation, inflammation and tumorigenesis. Biochim Biophys Acta, 2013, 1836(2): 245-254.
11. Milman N, Sengeløv H, Dombernowsky P. Iron status markers in patients with small cell carcinoma of the lung. Relation to survival. Br J Cancer, 1991, 64(5): 895-898.
12. Ferrigno D, Buccheri G. A comprehensive evaluation of serum ferritin levels in lung cancer patients. Lung Cancer, 1992, 8(2): 85-94.
13. Milman N, Pedersen LM. The serum ferritin concentration is a significant prognostic indicator of survival in primary lung cancer. Oncol Rep, 2002, 9(1): 193-198.
14. Erbaycu AE, Uçar H, Uslu O, et al. Prognostic significance of serum iron, iron-binding capacity, ferritin and bronchoalveolar lavage ferritin levels in primary lung cancer. UHOD-Uluslar Hematol, 2008, 18(4): 217-225.
15. 赵伟庆, 石红兵, 吴昌平, 等. 血清铁蛋白的表达与晚期肺癌患者预后的关系. 江苏医药, 2014, 40(24): 2978-2980.
16. 谢锦华, 吉浩明, 陈国栋, 等. 小细胞肺癌患者血清铁蛋白, 红细胞沉降率和红细胞平均指数水平与预后的关系. 国际肿瘤学杂志, 2018, 45(8): 465-469.
17. Ma C, Zuo W. Preoperative serum bilirubin levels associated with stage and prognosis in patients with stages I-III of non-small cell lung cancer in Jiangxi province, China. Int J Clin Exp Med, 2019, 12(8): 10433-10442.
18. Lee S, Jeon H, Shim B. Prognostic value of ferritin-to-hemoglobin ratio in patients with advanced non-small-cell lung cancer. J Cancer, 2019, 10(7): 1717-1725.
19. Wells G, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric, 2014, 18(6): 727-734.
20. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
21. Kuvibidila SR, Gauthier T, Rayford W. Serum ferritin levels and transferrin saturation in men with prostate cancer. J Natl Med Assoc, 2004, 96(5): 641-649.
22. Lorenzi M, Lorenzi B, Vernillo R. Serum ferritin in colorectal cancer patients and its prognostic evaluation. Int J Biol Markers, 2006, 21(4): 235-241.
23. Singh KJ, Singh SK, Suri A, et al. Serum ferritin in renal cell carcinoma: effect of tumor size, volume grade, and stage. Indian J Cancer, 2005, 42(4): 197-200.
24. Ashourpour M, Djalali M, Djazayery A, et al. Relationship between serum ferritin and inflammatory biomarkers with insulin resistance in a Persian population with type 2 diabetes and healthy people. Int J Food Sci Nutr, 2010, 61(3): 316-323.
25. 王彦, 林琳, 戢艳丽, 等. 术前红细胞分布宽度与食管癌患者预后关系的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2019, 26(12): 1247-1251.

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Association of the pretreatment serum ferritin concentration with prognosis in lung cancer patients: a meta-analysis

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