Diagnostic Significance of Serum Ferritin and Hepcidin as Complementary Biomarkers for Prostate Disease: A Prospective Case-Control Study in a Mission Hospital, Ghana

Currently, available evidence suggests prostate-specific antigen (PSA) is highly sensitive but poorly specific for prostate cancer detection in symptomatic patients and those with lower urinary tract symptoms. Serum ferritin and hepcidin, which are implicated in the pathogenesis of prostate cancers, may complement the diagnostic value of PSA. This study explored the correlation of serum PSA with ferritin and hepcidin as new and complementary diagnostic biomarkers for prostate disease.

This hospital-based case-control study was conducted at Methodist Hospital, Wenchi, with 90 participants. Venous blood sample was taken for complete blood count, PSA, ferritin, and hepcidin measurements using Mindray automated hematology analyzer and ELISA, respectively. Data were analyzed with SPSS version 27, and p < 0.05 was considered statistically significant.

Serum PSA levels were significantly higher among the Prostate Cancer patients compared to BPE patients [32.1 (18.2-47.6) vs. 18.3 (12.2-0.6), p < 0.001]. Levels of serum ferritin and hepcidin were found to be significantly higher in PCa patients compared to BPE and controls (p < 0.001). Serum PSA of prostate disease patients showed a strong positive correlation with levels of ferritin (r = 0.739, p < 0.001) but moderately correlated with serum hepcidin levels (r = 0.670, p < 0.001). Serum ferritin was found to be an excellent diagnostic marker for prostate cancer (AUC = 0.972, p < 0.001) and BPE (AUC = 0.900, p < 0.001). Serum hepcidin was a better marker for PCa (AUC = 0.911) but a poor BPE (AUC = 0.664, p = 0.023). Significant reduction in the levels of Hb, RBC, MCHC, and HCT but higher counts of TWBC and RDW-CV were observed in patients with prostate cancers compared to those with BPE and the normal control group (p < 0.05).

High levels of serum ferritin and hepcidin significantly correlated directly with increased serum total PSA levels and could play a valuable role to complement the noninvasive total PSA to improve diagnostic accuracy.