Studies on Iron Profile in Prostate Cancer Patients on Therapy at Imo State University Teaching Hospital, Orlu

Abstract

Prostate cancer (PCa) is a significant health problem in the ageing male, and changes in iron metabolism have been associated with cancer formation, progression, inflammation and oxidative stress. However, evidence on changes in iron profile in Nigerian men with prostate cancer is scarce. In this study, several iron profile characteristics in therapy-naïve prostate cancer patients were assessed and compared with that of men with benign prostatic hyperplasia (BPH) and seemingly healthy controls. It was a prospective comparative study of men attending the Imo State University Teaching Hospital, Orlu. Seventy-five therapy naïve patients with prostate cancer, 75 therapy naïve patients with BPH and 75 apparently healthy controls were studied. Serum prostate specific antigen (PSA), iron, ferritin and total iron binding capacity (TIBC) were evaluated using normal laboratory procedures. Data were analysed by SPSS version 23.0 and results were presented as mean ± standard deviation. Statistical significance was defined at p < 0.05 and groups were compared using the Independent Student’s t-test. Therapy naïve PCa patients had significantly higher concentration of PSA than controls (72.90 ± 10.09 vs. 2.04 ± 0.94 ng/mL; t = 54.27, p = 0.001) with significantly lower serum iron (79.31 ± 13.24 vs. 140.29 ± 18.34 µg/dL; t = -30.56, p = 0.001), higher ferritin (404.50 ± 92.02 vs. 108.07 ± 43.93; t = 22.27, p = 0.001) and lower TIBC (234.76 ± 40.00 vs. 335.67 ± 56.40 µg/dL; t = -10.15, p = 0.001). Similarly, BPH patients had significantly higher PSA, lower serum iron, greater ferritin and lower TIBC than controls (p < 0.001 for all comparisons). Direct comparison PCa and BPH showed significantly higher amounts of PSA and ferritin and significantly lower serum iron and TIBC concentrations in PCa patients (p < 0.001). In prostate cancer patients without therapy, we observed significant changes in parameters of iron profile: decreased levels of circulating iron and TIBC and increased levels of ferritin concentrations. The sequential pattern from controls, through BPH to PCa, indicates an increasing disturbance of systemic iron homeostasis in prostatic illness, with more dramatic abnormalities in prostate cancer. These data suggest that the evaluation of iron profile can give important auxiliary information regarding the metabolic and inflammatory milieu in prostate cancer, but these parameters cannot be regarded as independent diagnostic indicators