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However, the increase was comparable within the two types of cancer. Ratio of copper to ceruloplasmin was however not significantly different from controls. CEA is a tumour associated antigen, originally thought to be specific for GIT cancer (9) but is also found to be now elevated in other malignancies (10) and non-malignant disorders (11). However it continues to be used in follow up studies of patients with colon (12), breast (13) and lung cancers (14) and widely accepted as having prognostic significance. PSA, a member of the human kallikrein gene family (15) is fairly specific for prostate cancer, since the major site of PSA production is the glandular epithelium of prostate. Increased levels of serum PSA is thus associated with prostate pathology including malignancy (16). Sufficient evidence has been accumulated in the recent years to implicate trace elements in the etiology of cancer (17). Increased levels of copper were observed in lung (18), breast (2) and GIT (4) cancers. Increased levels of copper and ceruloplasmin were reported in Indian women with breast cancer (5). Cupric ions are reported to inhibit the production of singlet oxygen; this is of particular physiologic significance because of the latter's ability to cross the cell membrane and its high reactivity towards various biomolecules (19). Ceruloplasmin is an acute phase protein which increases in several malignancies and is a storage protein for copper in the liver. Increased levels of copper in serum of prostate and colon cancer patients may be due to the release of cytosolic and nuclear copper into the extracellular compartment. Secondaries in liver might be contributory to the high levels of ceruloplasmin. In the present study, there is a concomitant increase in copper
and ceruloplasmin levels in serum of both prostate and colon
cancer. Vaidya and Kamalakar (5) also reported a similar finding
in breast cancer patients. They reported that these parameters
came back to normal values after undergoing treatment. Elevation
of serum copper and ceruloplasmin levels have also been reported
to be useful in diagnosis and prognosis of other malignancies
(20). Hence determination of serum copper and ceruloplasmin
could be useful in diagnosis, prognosis and therapy evaluation
of prostate and colon cancer patients along with PSA and CEA. 1. Rao DN, Ganesh B. Estimate of cancer incidence in India in 1991. Ind J Cancer 1998; 35: 10-18. 2. Huang YL, Shen JV, Lin TH. Association between oxidative stress and changes of trace elements in patients with breast cancer. Clin Biochem 1999; 32(2): 131-136. 3. Aryumanayagam M, Wong FW, Rogers M, Swaminathan R. Serum ceruloplasmin, plasma copper concentration and copper to ceruloplasmin ratio in cervical cancer. Gynaec Obst Invest 1993; 35(3): 175-178. 4. Narang AP, Verma A, Kumar GR, Sanyal B. Serum copper levels in GIT cancer. J Trace Elem Elecetro Health Dis 1989; 3(3): 147-150. 5. Vaidya SM, Kamalakar PL. Copper and ceruloplasmin levels in serum of women with breast cancer. Ind J Med Sci 1998; 52(5): 184-187. 6. Zak B, Landers JW Copper in serum. J Clin Pathol 1958;29:590-592. 7. Ravan HA, Copper oxidase activity. J Lab Clin Med 1961;58:161-163. 8. Wayne PA. National committee for clinical laboratory standards. Approved guidelines NCCCLS procurement 1/LA 19-A: NCCLS: 1997. 9. Skarin AT, Delwiche R. Careinoembryonic antigen : clinical correlation ith chemotherapy for metastatic GIT cancer. Cancer 1974; 33: 1239-1244. 10. Reynosa G, Chu TM. Carcinoeiiibryonic antigen in patients with different cancers. JAMA 1972; 220: 361-363. 11. Alsabti EAK, Kaniel A. Carcinoembryonic antigen in patients with malignant and non-malignant disease. Neoplasm 1979; 26: 603-606. 12. Martin EW, Cooperman M. A retrospective and prospective study of cervical determinations in the early detection of recurrent colon cancer. Am J Surg 1979; 137: 167-171. 13. Steward AM, Nixen D. Carcinoembryonic antigen in breast cancer patients : Serum levels and disease progress. Cancer 1974; 33: 1246-1247. 14. Concannon JP, Dawbow MH. Prognostic value of preoperative carcinoembryonic antigen plasma levels in patients with bronchogenic carcinoma. Cancer 1978; 42: 1477-1479. 15. McCormack RT, Rittenhouse HG, Finlay JA. Molecular forms of prostatic specific antigen and the human kallikrein gene family : a new era Urology 1995; 45: 729-744. 16. Partin AW, Desterling JE. The clinical usefulness of prostatic specific antigen Update 1994. J Urol 1994;152:1358-1368. 17. Jayadeep A, Raveendran PK, Kannan S, Nalini Kumari KR, Mathew B, Krishnan N, Menon VP. Serum levels of copper, zinc, iron and ceruloplasmin in oral leukoplakia and squamous cell carcinoma. J Exp Clin Cancer Res 1997; 16(3): 295-300. 18. Zhao X, Han C, Jing J. Relationship of serum trace elements to lung cancer and its clinical application. Chung Hua Liu Hsing Ping Hsuch Tsa Chih 1998; 19(5): 286-287. 19. Joshi PC. Copper (II) as an efficient scavenger of singlet molecular oxygen. Ind Biochem Biophys 1998; 35(4): 208-215. 20. Rajput BS, Gupta SN, Sur KN, Pandey RP, Singh S. Evaluation of serum copper levels in diagnosis and prognosis of various malignancies. Ind J Surgery 1979; 41: 375-379. |
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