To investigate the correlation between the serum ferritin (SF) and clinical prognosis of patients with primary liver cancer (PLC).

Clinical data of 380 patients with PLC admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to January 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 339 patients were male and 41 female, aged from 21 to 86 years with a median age of 54 years. According to the SF reference value, all patients were divided into the normal SF and high SF groups. The survival of patients was followed up. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The correlation between SF level and clinical prognosis of PLC patients was analyzed by Cox's proportional hazard regression model.

The 1-, 2- and 3-year survival rates were 62.9%, 45.3%, and 16.8%, respectively. Cox's regression analysis showed that SF, TNM staging and treatment were the independent risk factors for the clinical prognosis of PLC patients (OR=1.771, 3.695, 0.224; P<0.05). Survival analysis showed that the overall survival of PLC patients with elevated SF was significantly worse than those with normal SF (χ²=11.530, P<0.05). For the patients receiving TACE, subgroup analysis result revealed that the overall survival of patients with elevated SF was significantly worse than those with normal SF (χ²=10.120, P<0.05).

The expression level of SF is associated with the clinical prognosis of PLC patients. Elevated SF levels indicates shorter survival time.