Abstract: Objective To study the relationships between the expression level of mitochondrialferritin (FtMt) and the clinical pathology and molecular characteristics in non-small cell lung cancer (NSCLC). Methods A total of 154 surgical specimens with pathologically confirmed NSCLCfrom September 2018 to December 2020 were selected. Immunohistochemistry was used to determine the expression of FtMt protein. Amplification refractory mutation system was used to detect the mutations of EGFR, ALK, and KRAS genes. Fluorescence quantitative PCR was used to detect the mRNA expression levels of epithelial-mesenchymal transformation markers N-cadherin, E-cadherin, Vimentin, and mitochondrial pathway apoptotic proteins B-lymphoblastoma-2 (Bcl-2), Bcl2-associated X-protein ( Bax), caspase-3, and ferroptosis markers glutathione peroxidase 4 ( GPX4), solute carrier family 7 member 11 (SLC7A11). Patients with NSCLC were followed-up for the tumorfree survival and overall survival. Results The positive expression rate of FtMt in the NSCLC tissueswas higher than that in the adjacent tissues ( P < 0. 05). The positive expression rates of FtMt inNSCLC tissues with low differentiation, pTNM stage Ⅲ , and lymph node metastasis were higherthan those with high differentiation, pTNM stage Ⅰ -Ⅱ , and no lymph node metastasis ( P <0. 05). The mRNA expression levels of N-cadherin, Vimentin, Bcl-2, GPX4, SLC7A11 and the mutant rate of EGFR in the NSCLC tissues with positive FtMt expression were increased, while themRNA expression levels of E-cadherin, Bax, and Caspase-3, as well as the tumor free survival rate and overall survival rate were decreased when compared with those in the NSCLC tissues withnegative FtMt expressions (P < 0. 05). Conclusion The positive expression of FtMt in NSCLC isassociated with pathological progression, EGFR mutation, and reduced survival. The biologicalmechanisms may associate with abnormal epithelial mesenchymal transformation, ferroptosis and mitochondrial pathway apoptosis.

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