417. Adv Exp Med Biol. 1989;258:273-85.
Serum copper concentration as an index of clinical lung injury.
Molteni A(1), Ward WF, Kim YT, Shetty R, Brizio-Molteni L, Giura R, Ribner H,
Lomont M.
Author information:
(1)Department of Pathology, Northwestern University Medical School, Chicago, IL
60611.
The purpose of this ongoing study is to determine whether thoracic radiotherapy
for lung cancer produces an early increase in serum copper (Cu) concentration, an
increase which might predict clinical outcome. Copper and iron concentrations
were measured in serum obtained from nonsmall cell lung cancer patients at 0, 1,
2, 4, and 6 weeks after the start of radiotherapy. Control groups included
patients irradiated for breast cancer (low dose of radiation to the lung), for
endometrial, cervical or prostatic cancer (no dose to lung), and patients with
congestive heart failure, pulmonary hypertension, chronic obstructive pulmonary
disease (COPD), and cutaneous burns with or without smoke inhalation (no
irradiation). Serum Cu concentration increased at least 10 micrograms/dl from the
pretreatment level in approximately 75% of the adenocarcinoma and squamous cell
lung cancer patients, but in only 1 of 4 undifferentiated lung cancer cases. In
virtually all of these responders, serum Cu increased to a maximum at 2 weeks
after the start of therapy, then plateaued or decreased slightly despite
continuing irradiation. Within the subset of squamous cell lung cancers, there
was a direct correlation between the degree of histologic differentiation and
both baseline serum Cu concentration and the probability of an early increase
therein. In contrast, only 33% of breast cancer patients and 15% of endometrial,
cervical and prostate cancer patients exhibited an increase in serum Cu
concentration at 2 weeks after the start of radiotherapy. Serum Cu concentration
was within normal limits in virtually all patients with congestive heart failure,
pulmonary hypertension, and COPD. Burn patients exhibited a significant reduction
in serum Cu, although concomitant smoke inhalation increased serum Cu back to
low-normal levels. Serum iron concentration did not change significantly in any
category of patients. These data suggest that thoracic radiotherapy for well
differentiated non-small cell lung cancer is accompanied by an early increase in
serum Cu concentration. This increase is partly but not wholly related to lung
dose in particular rather than tissue dose in general, and specifically reflects
radiation-induced lung injury rather than pneumopathy in general. In lung cancer
patients, the change in serum Cu concentration during the first 2 weeks of
radiotherapy exhibits a sufficiently broad range (+60 to -13 micrograms/dl) to
permit testing this parameter as a predictor of tumor response and pulmonary
complications.
PMID: 2626991 [PubMed - indexed for MEDLINE]