Serum copper level (SCL), serum zinc level (SZL), and SCUSZL ratio were measured in 18 patients with biopsy-proven osteogenic sarcoma. Measurements were made on sequentially collected serum samples beginning prior to the institution of therapy and continuing periodically until documented relapse. All patients were treated by curative resection and adjuvant therapy consisting of high dose methotrexate (with leucovorin rescue) with or without BCG immunotherapy. The SCL, SZL, and SCUSZL determinations were made using proton-induced x-ray fluorescence spectrometry. SCL was significantly elevated (p < .0001) in the 18 patients with primary untreated osteogenic sarcoma (173 ? 30 pg/dl) compared with a sex and age-matched normal group (115 * 16 pg/dl). A significantly different SZL was not found, however, so that an elevated SCUSZL ratio in the osteogenic sarcoma patients was primarily due to the altered SCL. SCL and SCUSZL did not change significantly following curative surgery or become more abnormal in those patients who developed recurrent disease. The SCL and SCUSZL were noted to be markedly elevated in those patients receiving BCG therapy, thus raising concern regarding the specificity of these tests as markers of tumor activity. SCL, SZL, and SCUSZL did not appear useful as markers of tumor activity in patients with osteogenic sarcoma.Cancer 42:598-602, 1978.STEOGENIC SARCOMA ARISES at a rate of 0 1 per 100,000 persons in the U. S.6The 5-year survival rate for patients with osteogenic sarcoma treated with presumed curative surgery is about 20%,9 with a median survival of 16.5 months.16 The median time to the appearance of metastases is approximately 10 months, with the most common site of relapse being the lung. Recently adjuvant chemotherapy with high dose methotrexate or adriamycin has been e m p l~y e d ,~, '~ in the hope of improving the survival rates.Monitoring progression of disease in these patients has depended for the most part on radiographic demonstration of metastases.

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A study of human blood serum is utilized to demonstrate both the x-ray emission caused by electrons dropping into atomic inner-shell vacancies produced by proton bombardment and the application of such x-ray emissions to trace element analysis. Sample preparation consisted solely of pipetting 25 μl of serum onto low-ash filter paper. Characteristic Kα x rays from copper and zinc were detected by a Si(Li) semiconductor detector to determine trace concentrations of these essential biological metals in the blood. The copper and zinc concentrations in the blood serum sample analyzed were found to be 1.16±0.13 and 0.70±0.07 ng/μl, respectively.