title: Diagnostic value of the copper/zinc ratio in hepatocellular carcinoma: a case control study.
abstract: BACKGROUND
  The aim of this study was to assess the accuracy of the copper/zinc ratio in the evaluation of a group of patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 105 patients were studied and separated into three groups: group I ( n = 40), patients with HCC, group II ( n = 25), patients with liver cirrhosis, and group III ( n = 40), patients with benign digestive disease. Serum levels of copper and zinc were measured by atomic absorption spectrophotometry.
  
  
  RESULTS
  The serum levels of copper microg/dl) in patients with HCC (97.4 +/- 27.2; P < 0.05) were significantly higher than those in patients with liver cirrhosis (73.7 +/- 17.5) or benign digestive disease (77.1 +/- 20.8), and the serum levels of zinc microg/dl) were significantly lower (71.6 +/- 30.5; P < 0.05) than those in patients with benign digestive disease (81.7 +/- 17.7 microg/dl) and were similar to those in cirrhotic patients (68.5 +/- 17.1). The Cu/Zn ratio was also significantly higher in patients with HCC (1.52 +/- 0.64; P < 0.05) than in patients with liver cirrhosis (1.06 +/- 0.2) or patients with benign digestive disease (0.95 +/- 0.39). Considering a cutoff value of 1.15, the sensitivity of the Cu/Zn ratio was 87.5%, with a specificity of 86.1%, a positive predictive value of 79.5%, and a negative predictive value of 91.8%.
  
  
  CONCLUSIONS
  The Cu/Zn ratio was found to be significantly higher in patients with HCC compared with that in age and sex-matched controls, with a sensitivity of 87.5%; this ratio might be useful in the evaluation of suspected hepatocellular malignancy.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, and Hospital Médica Sur, Mexico City, Mexico.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Poo
authors.forename: Reina
authors.initials: R
authors.lastname: Rosas-Romero
authors.forename: Ana C
authors.initials: AC
authors.lastname: Montemayor
authors.forename: Fernando
authors.initials: F
authors.lastname: Isoard
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis*; D016022:Case-Control Studies; D003300:Copper / Q000097:blood*; D004066:Digestive System Diseases / Q000175:diagnosis; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013054:Spectrophotometry, Atomic; D015032:Zinc / Q000097:blood*
chemical_list: D003300:Copper; D015032:Zinc