Ferritin above 100 mcg/L could rule out colon cancer, but not gastric or rectal cancer in patients with involuntary weight loss Full Text
BMC Gastroenterology, 07/24/2012
Baicus C et al. – In patients with involuntary weight loss, a ferritin above 100mcg/L could rule out colon cancer, but not gastric or rectal cancer.Methods
- All consecutive patients with IWL admitted in a secondary care university hospital were prospectively studied.
- Ferritin, haemoglobin with erythrocyte indices and serum iron were recorded for all patients.
- The reference standard was bidirectional endoscopy and/or 6 months follow–up.
- 290 patients were included, a quarter had cancer, of which 22 (7.6%) had gastrointestinal cancer (8 gastric cancer, 1 ileum cancer, 13 colorectal cancer).
- Ferritin had the best area under the curve (AUC), both for gastrointestinal cancer (0.746, CI: 0.691–0.794), and colorectal cancer (0.765, CI: 0.713–0.813), compared to the other parameters of iron deficiency.
- In the diagnosis of colorectal cancer, ferritin with a cut–off value of 100 mcg/L had a sensitivity of 93% (CI: 69–100%), and negative likelihood ratio of 0.13, with a negative predictive value of 99% (96–100%), while for gastrointestinal cancer, the sensitivity was lower (89%, CI: 67–95%), with a negative likelihood ratio of 0.24.
- There were three false negative patients, two with gastric cancer, and one with rectal cancer.