Classification and prognostic value of serum copper/zinc ratio in Hodgkin's disease

The serum copper and zinc levels were determined by atomic absorption spectrometry in 135 Hodgkin's disease (HD) patients and in 100 healthy controls. These values were used to explore the application value of the serum copper/zinc ratio in the histologic classification and prognosis in this illness. The resuls show that serum copper and the copper/zinc ratio were higher and the serum zinc level was lower in the HD patients when compared to the healthy individuals (p < 0.01, 0.001, and 0.01, respectively). The serum copper and copper/zinc ratio were significantly higher in the lymphocyte-depleted type of HD than in the patients with the mixed-cellular type of HD. These values were also higher and the serum zinc was lower in the patients with mixed-cellular HD when compared to the nodular-sclerosis and the lymphocyte-predominant types of the disease (p < 0.01 and 0.001, respectively). It was also shown that as the disease progresses, the serum copper level and copper/zinc ratio rises with the concomitant decrease of the corresponding serum zinc level. These trends are reversed in cases where the disease is in remission. Both the serum copper level and the copper/zinc ratio were strongly correlated to histopathological changes, clinical stage, and prognosis of Hodgkin's disease.