University of Oulu

Väyrynen, J., Tuomisto, A., Väyrynen, S., Klintrup, K., Karhu, T., Mäkelä, J., Herzig, K., Karttunen, T., Mäkinen, M. (2018) Preoperative anemia in colorectal cancer: relationships with tumor characteristics, systemic inflammation, and survival. Scientific Reports, 8 (1). doi:10.1038/s41598-018-19572-y

Preoperative anemia in colorectal cancer : relationships with tumor characteristics, systemic inflammation, and survival

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Author: Väyrynen, Juha P.1,2; Tuomisto, Anne1,2; Väyrynen, Sara A.1,2;
Organizations: 1Cancer and Translational Medicine Research Unit, University of Oulu
2Department of Pathology, Oulu University Hospital and Medical Research Center Oulu
3Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu
4Department of Surgery, Oulu University Hospital and Medical Research Center Oulu
5Research Unit of Biomedicine and Biocenter of Oulu, University of Oulu
6Oulu University Hospital and Medical Research Center Oulu
7Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
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Language: English
Published: Springer Nature, 2018
Publish Date: 2018-04-09


Anemia is common in colorectal cancer (CRC) but its relationships with tumor characteristics, systemic inflammation, and survival have not been well characterized. In this study, blood hemoglobin levels and erythrocyte mean corpuscular volume (MCV) levels were measured in two independent cohorts of 148 CRC patients and 208 CRC patients, and their correlation with patient and tumor characteristics, systemic inflammatory markers (modified Glasgow Prognostic Score: mGPS; serum levels of thirteen cytokines, C-reactive protein, albumin), and survival were analyzed. We found that anemia, most frequently normocytic, followed by microcytic, was present in 43% of the patients. Microcytic anemia was most commonly associated with proximal colon tumor location. Average MCV and blood hemoglobin levels were lower in tumors with high T-class. Low blood hemoglobin associated with systemic inflammation, including high mGPS and high serum levels of C-reactive protein and IL-8. Particularly, normocytic anemia associated with higher mGPS. Normocytic anemia associated with a tendency towards worse overall survival (multivariate hazard ratio 1.61, 95% confidence interval 1.07–2.42, p = 0.023; borderline statistical significance considering multiple hypothesis testing). In conclusion, anemia in CRC patients is most frequently normocytic. Proximal tumor location is associated with predominantly microcytic anemia and systemic inflammation is associated with normocytic anemia.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 8
Article number: 1126
DOI: 10.1038/s41598-018-19572-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
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