Utility of ferritin and inflammatory biomarkers in the diagnosis of different stages of breast cancer

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Figure 1
- Comparison of log ferritin/hemoglobin (Hb) ratio between the study groups
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Figure 2
- Correlation of hemoglobin with serum ferritin levels (correlation coefficient= -0.6130, p<0.0001)
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Figure 3
- Receiver operating characteristic curve analyses for the diagnosis and differentiation of the stages of breast cancer. A) Differentiation of healthy controls and breast cancer patients using Ferritin. B) Differentiation of stage 3 and stage 4 of breast cancer using Ferritin. C) Differentiation of healthy controls and breast cancer patients using Ferritin/Hb ratio. D) Differentiation of stage 3 and stage 4 of breast cancer using Ferritin/Hb ratio. AUC: Area under curve

Table 1

- Comparison of study parameters between controls and breast cancer patients.

Parameters	Control (n=20)	Cases (n=60)	P-value
Hb (g/dL)	12.40 (12.10-12.50)	10.95 (10.33-11.80)	<0.0001^*
HsCRP (ng/ml)	3686 (463.2-7628)	6008 (2653-19032)	0.0326^*
Hepcidin (pg/ml)	73710 (9263-512749)	120165 (53060-640558)	0.0397^*
Ferritin (ng/ml)	29.70 (25.73-45.70)	82.95 (52.65-167.9)	<0.0001^*
Ferritin/Hb ratio	2.458 (2.035-3.757)	7.590 (4.859-16.02)	<0.0001^*

Table 2

- Comparison of study parameters between controls and breast cancer patients in different stages of the diseases.

Parameters	Control (n=20)	Stage 1&2 (n=20)	Stage 3 (n=20)	Stage 4 (n=20)
Hb (g/dl)	12.40 (12.10-12.50)	11.65 (10.68-12.33)^*	11.20 (10.13-11.78)^{^††††}	10.50 (10.23-10.88)^{^§,^‡‡‡‡}
Hepcidin (pg/ml)	73710 (9263-152564)	87725 (44175-179148)	122348 (30678-367928)	224315 (78415-457778)^{^‡}
hsCRP (ng/ml)	3686 (463.2-7628)	4386 (2209-8957)	6117 (1534-18396)	11216 (3921-22889)^{^‡}
Ferritin (ng/ml)	29.70 (25.73-45.70)	56.35 (50.73-78.55)^{^**}	66.90 (50.23-96.25)^{^†††}	178.9 (137.0-209.5)^{^‡‡‡‡,^§§§,^††}
Ferritin/Hb ratio	2.458 (2.035-3.757)	5.501 (4.291-6.713)^{^**}	5.580 (4.737-8.759)^{^†††}	16.86 (13.03-20.22)^{^‡‡‡‡,^§§§,^††}
Log ferritin/Hb ratio	0.1184 (0.1133- 0.1343)	0.1571 (0.1473- 0.1652)^{^**}	0.1635 (0.1490 -0.1840)^{^†††}	0.2118 (0.1987-0.2244)^{^‡‡‡‡,^§§§,^††}
N/L ratio	1.90 (1.467- 2.225)	1.60 (1.194- 2.211)	1.71 (1.222 - 2.298)	3.149 (2.104-4.591)^{‡‡,^§§§,^††}

All data expressed as Median (Inter Quartile Range).P-value <0.05 is considered as significant.
↵* control vs. stage 1&2;
^† control vs. stage 3;
↵^‡ control vs. stage 4;
↵^§ stage 1&2 vs. stage 4,
↵^†† stage3 vs. stage 4,
^‡ p-value <0.05;
↵^{**, ††} p-value <0.01;
↵^{†††, §§§} p-value <0.001;
↵^{††††, ‡‡‡‡} p-value <0.0001

Table 3

- Comparison of lipid profile between controls and breast cancer patients in different stages of the disease.

Parameters	Control (n=20)	Stage 1&2 (n=20)	Stage 3 (n=20)	Stage 4 (n=20)
Total cholesterol (mg/dl)^*	172.95±19.24	203.70±30.91^{^†}	216.75±29.34^{^‡‡‡}	199.65±43.06^{^§}
HDL-c (mg/dl)^*	42.55±7.85	46.10±5.94	48.15±11.43	46.45±11.24
LDL-c (mg/dl)	110.5(32)	140(63.3)	141.5 (30)^{^‡‡}	119.5(47.5)
VLDL-c (mg/dl)	25.50(14)	25.50(25.5)	21.0(9)	24.0(13.5)
TG (mg/dl)	128.0(78)	126.5(127.3)	110.0(52.25)	122.0(65.75)

↵* Data expressed as mean ± SD. All other data expressed as Median (Inter Quartile Range).
↵^† control vs. stage 1&2;
^‡ control vs. stage 3;
↵^§ control vs stage 4;
^{†, §} p-value <0.05;
↵^‡‡ p-value <0.01;
↵^‡‡‡ p-value <0.001