The association between cancer-related anemia and KRAS protein expression in colorectal cancer patients

Background: Cancer-related anemia (CRA) has been implicated as one of the crucial key players in the prognosis, quality of life and survival rates in colorectal cancer (CRC) patients. The study of interlacing relation between the type and pathogenesis of CRA with KRAS expression as well as tumor side can dramatically help decipher the prognosis and means of amelioration of CRC patients quality of life. Patients and methods and results: A retrospective data analysis of 120 newly diagnosed CRC patients who were subjected to KRAS protein expression analysis using immunohistochemistry, and their peripheral blood samples taken before neoadjuvant therapy, has been analyzed for their complete blood picture, and complete iron profile. KRAS expression was significantly associated with iron deficiency hypochromic microcytic anemia, as well as the prevailing incidence of KRAS expression with higher immunoscore and more advanced stage at diagnosis among right-sided CRC patients; associated with significantly more severe iron deficiency hypochromic microcytic anemia. Conclusion: A substantial proof of the higher prevalence of microcytic anemia and iron deficiency anemia among KRAS positive CRC patients; suggesting that it is the more prominent type of anemia among these patients; as well as more prevalent among patients with right-sided CRC than among the left-sided CRC. Iron deficiency anemia, KRAS positive expression, and right-sided colorectal tumors form an interlacing web tightly correlated with more advanced tumor nodes metastasis staging at diagnosis, worse quality of life, and inferior prognosis.