Integrated Analysis of Interleukin-10, Transforming Growth Factor-beta, and Estrogen in Relation to Cervical Cancer Progression among Women with Iron-deficiency Anemia

BACKGROUND: Complex immunological, hormonal, and metabolic changes have been linked to the progression of cervical cancer, which also includes changes in iron-deficiency anemia. AIMS OF THE STUDY: The study aimed to assess the relationship between cervical cancer stage, interleukin-10 (IL-10), transforming growth factor-beta (TGF-β), and estrogen levels in women with IDA. METHODOLOGY: This case–control study was conducted on 170 women who were recruited from Al-Habboubi Teaching Hospital, Iraq, from January 2024 to June 2025. The study comprised 120 female patients with cervical cancer and IDA and 50 healthy controls. According to the FIGO criteria, tumor staging was carried out. Estrogen was measured by chemiluminescent immunoassay, and IL-10 and TGF-β were measured by enzyme-linked immunosorbent assay. Hematological and biochemical parameters such as ferritin, transferrin saturation, C-reactive protein (CRP), and complete blood count indices were also assessed. RESULTS: The concentration of hemoglobin, ferritin, transferrin saturation, and IL-10 was significantly decreased in patients with cervical cancer compared with controls ( P < 0.001), while body mass index, TGF-β, estrogen, and CRP levels were significantly elevated ( P < 0.001) in patients with cervical cancer. As the tumor advanced, the levels of IL-10, ferritin decreased, while those of TGF-β and estrogen increased. Correlation analysis revealed significant correlations between the levels of biomarkers and severity of the disease. Elevated levels of TGF-β and estrogen were independently associated with advanced disease, while IL-10 was associated in a protective manner, by multivariate logistic regression. CONCLUSIONS: Women with IDA have lower levels of IL-10 and higher levels of TGF-β and estrogen when progressing to cervical cancer, suggesting that the progression of IDA to cervical cancer involves immune dysregulation, activation of inflammation, hormonal imbalance, and dysfunction of iron metabolism.