International Journal of Hematology

, Volume 96, Issue 2, pp 214–221 | Cite as

Cutoff values of serum ferritin and TIBC saturation for the evaluation of gastrointestinal neoplasms in adult anemic patients

  • Mark Hong Lee
  • Eugene Park
  • Jongchan Lee
  • So Young Kim
  • Sung Yong Kim
  • Sun Young Lee
  • Yo Han Cho
  • So Young Yoon
Original Article


We conducted a retrospective study to find out the optimum values of serum ferritin and other hematologic indices in adult anemic patients who should be referred for thorough gastrointestinal (GI) endoscopic evaluation for GI neoplasms. 544 adult anemic patients were stratified into three groups according to the results of GI endoscopy: benign versus premalignant versus malignant. As compared to non-malignant groups, malignant group demonstrated statistically significant differences in terms of median values of ferritin and total iron-binding capacity (TIBC) saturation. By receiver operating characteristics curve analyses to find out optimum cut-off points of the serum ferritin and TIBC saturation which distinguish between non-malignant diseases and malignant diseases, the cut-off ferritin value of 44.33 ng/mL in male had 72.73 % sensitivity and 70.95 % specificity. The cut-off TIBC saturation value of 9.13 % in male had 73.33 % sensitivity and 70.92 % specificity. The cut-off TIBC saturation value of 6.16 % in female had 69.57 % sensitivity and 65.13 % specificity. It is recommended that adult male patients with anemia undergo thorough endoscopic evaluation to detect GI neoplasms when their serum ferritin levels are ≤44 ng/mL or TIBC saturation values are ≤9 %. For adult female, only TIBC saturation values less than 6 % may contribute to determining whether they undergo GI endoscopic evaluation.


Ferritins Anemia Iron deficiency Gastrointestinal neoplasms Endoscopy Gastrointestinal 


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Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Mark Hong Lee
    • 1
  • Eugene Park
    • 1
  • Jongchan Lee
    • 2
  • So Young Kim
    • 3
  • Sung Yong Kim
    • 1
  • Sun Young Lee
    • 3
  • Yo Han Cho
    • 1
  • So Young Yoon
    • 1
  1. 1.Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical CenterKonkuk University School of Medicine SeoulSeoulKorea
  2. 2.Department of StatisticsKorea UniversitySeoulKorea
  3. 3.Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical CenterKonkuk University School of MedicineSeoulKorea

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