Serum zinc and copper changes after gastrectomy in aged patients with gastric cancer

Serum zinc and copper levels were evaluated in patients with gastric cancer who had undergone gastrectomy. These patients were divided into two age categories; namely, the aged group, comprising 39 patients over the age of 70 years, and the younger group, comprising 23 patients younger than 50 years. The data before and after surgery were compared between the two groups. Serum zinc levels in the aged group were significantly lower than those in the younger group, both before and after surgery. Serum copper levels, however, did not differ significantly between the two groups. The serum Cu/Zn ratio was also analyzed according to the histological stages of cancer (stages I to IV), and compared between the two age-classified groups. The aged group showed a higher Cu/Zn ratio at all stages, whereas in the younger group, the ratio was significantly higher at stage IV than in the earlier stages. Preoperative serum zinc, copper, and the Cu/Zn ratio were studied in relation to the complication of anastomotic leak after surgery. The Cu/Zn ratio in the aged patients with this complication was significantly higher than that in the aged patients without it. These results suggest that the Cu/Zn ratio may be an important factor in determining nutritional parameters in the aged.