Anemic syndrome in patients with rectal cancer

Background. It is known that anemic syndrome (AS) is often detected in cancer patients during disease diagnosis. AS, along with tumor size and disease stage, is considered as an independent prognostic factor affecting survival. Aim. To analyze hematological parameters of peripheral blood and ferrokinetic parameters to clarify the role of hepcidin (GP-25), interleukin 6 (IL-6) in early and differential diagnostics of AS variants in patients with rectal cancer (RC). Materials and methods. The study was conducted in 32 patients with RC before treatment. Hematological parameters of peripheral blood were studied on a Sysmex XE-2100 analyzer (Japan). Determination of the concentration of ferritin, GP-25, IL-6, erythropoietin was performed in blood plasma using ELISA. Results. Almost half (47 %) of the patients with RC had AS in two variants: iron deficiency anemia and functional iron deficiency (FID). All variants were characterized by microcytosis, hypochromia of erythrocytes and reticulocytes, which indicated iron deficiency erythropoiesis. However, in patients with stages III–IV of the disease and with FID, the concentration of ferritin, GP-25, IL-6, the number of erythrocyte fragmentocytes was statistically significantly higher, and the levels of erythrocytes, hemoglobin, hematocrit were lower than in patients with iron deficiency anemia. This indicated a long-term process of AS formation or anemia of chronic disease with FID. Deviations from the reference value of GP-25 and ferritin levels were detected not only in patients with AS, but also in individual patients without hematological signs of anemia, which did not exclude the latent stage of AS. Erythropoietin deficiency relative to the severity of AS was established in all variants. Conclusion. The study was small in number, which does not allow us to draw an unambiguous conclusion about the role of GP-25 and IL-6 in the pathogenesis of the AS variant with FJ in patients with RC and requires further study.