PURPOSE Iron is essential to energy metabolism, cell proliferation and DNA synthesis, and sufficient iron availability may be required for tumor growth. The hormone hepcidin is a systemic regulator of iron concentration in plasma. Intra-tumor RNA expression of hepcidin has been linked to shorter metastasis-free survival in women with early breast cancer, but the prognostic implications of this inflammatory marker and iron-regulating plasma peptide in the blood are unknown. METHODS Using an ELISA assay, hepcidin was measured in the banked blood of 518 women who were recruited from 1989 to 1996 for a prospective cohort study of diet and lifestyle factors in breast cancer. Blood samples were obtained 4-12 weeks post-operatively, prior to treatment with chemotherapy or tamoxifen. RESULTS Hepcidin was not associated with time to distant breast cancer recurrence (primary outcome) nor time to death from any cause. However, a pre-planned interaction test of body mass index (BMI) was statistically significant (p < 0.01). Among obese women (BMI > 30 kg/m2), higher hepcidin was associated with a shorter time to distant breast cancer recurrence in both uni- and multivariable analyses (adjusted HR 1.84; 95% CI 1.04-3.25). For overall survival, a similar pattern was seen in the univariable model but the effect was diminished in a multivariable analysis. Plasma hepcidin was not associated with high-sensitivity C-reactive protein, but it was significantly associated (r ≥ 0.32) with iron indices, including total iron (p < 0.01), transferrin (p < 0.01) and soluble transferrin receptor (p < 0.01). CONCLUSIONS Hepcidin may be associated with poor breast cancer outcome in obese women, however, replication is required. The biologic basis for this prognostic association requires further research.

中文翻译：

---

血浆铁调素与早期乳腺癌女性的预后相关性。

目的 铁对能量代谢、细胞增殖和 DNA 合成至关重要，肿瘤生长可能需要足够的铁供应。激素铁调素是血浆中铁浓度的全身调节剂。铁调素的肿瘤内 RNA 表达与早期乳腺癌女性的无转移生存期较短有关，但这种炎症标志物和血液中的铁调节血浆肽的预后意义尚不清楚。方法 使用 ELISA 测定法，在 1989 年至 1996 年招募的 518 名女性的银行血液中测量铁调素，用于乳腺癌饮食和生活方式因素的前瞻性队列研究。在用化疗或他莫昔芬治疗之前，在术后 4-12 周采集血样。结果 铁调素与远处乳腺癌复发的时间（主要结果）和任何原因导致的死亡时间无关。然而，预先计划的体重指数 (BMI) 相互作用测试具有统计学意义 (p < 0.01)。在肥胖女性（BMI > 30 kg/m2）中，在单变量和多变量分析中，较高的铁调素与较短的远处乳腺癌复发时间相关（调整后的 HR 1.84；95% CI 1.04-3.25）。对于总生存期，在单变量模型中看到了类似的模式，但在多变量分析中效果减弱了。血浆铁调素与高敏 C 反应蛋白无关，但与铁指数显着相关（r ≥ 0.32），包括总铁（p < 0.01）、转铁蛋白（p < 0.01）和可溶性转铁蛋白受体（p < 0.01)。结论 铁调素可能与肥胖女性乳腺癌预后不良有关，但需要进行复制。这种预后关联的生物学基础需要进一步研究。