Serum hepcidin concentration is lower in advanced stages of sporadic colorectal cancer.

Introduction: Hepcidin (Hep), a key regulatory hormone of iron (Fe) homeostasis, governs its absorption and storage, and is influenced by inflammation and Fe status. This study investigated serum Hep concentrations and their associations with Fe markers and inflammation in patients with sporadic colorectal cancer (CRC).

Materials and methods: We compared serum concentrations of Hep, Fe, unsaturated and total iron binding capacity, transferrin, transferrin saturation, ferritin, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor markers in 82 CRC patients and 58 controls. Statistically significant differences were tested using the Mann-Whitney U test and Student's t test. Additionally, Hep were analyzed according to tumor stage. Colorectal cancer was confirmed histopathologically after colonoscopy with biopsy (TNM staging).

Results: Colorectal cancer patients exhibited significantly lower Hep concentrations than controls (8.1 vs. 19.7 ng/mL, P = 0.020). Ferritin was also lower in CRC (109 vs. 250 µg/L, P = 0.002). Hepcidin showed the strongest positive correlation with ferritin in CRC. Inflammatory markers (CRP and IL-6) correlated moderately to weakly with hepcidin in both groups (controls: rho = 0.52 (P < 0.001); CRC: rho = 0.26 (P = 0.022) for CRP and CRC: rho = 0.30 (P = 0.033) for IL-6). Notably, Hep concentrations were lower in patients with advanced tumor stage (T0 vs. T3, P = 0.043).

Conclusion: These findings suggest that CRC is associated with lower hepcidin and ferritin concentrations, potentially reflecting complex and cancer-specific dysregulation in Fe metabolism beyond inflammation alone.