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Clinical and Epidemiological Investigations

Neopterin as a Prognostic Indicator in Patients with Carcinoma of the Uterine Cervix

Gilbert J. Reibnegger, Alfred H. Bichler, Otto Dapunt, Dietmar N. Fuchs, Lothar C. Fuith, Arno Hausen, Heinz M. Hetzel, Hermann Lutz, Ernst R. Werner and Helmut Wachter
Gilbert J. Reibnegger
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Alfred H. Bichler
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Otto Dapunt
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Dietmar N. Fuchs
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Lothar C. Fuith
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Arno Hausen
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Heinz M. Hetzel
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Hermann Lutz
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Ernst R. Werner
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Helmut Wachter
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DOI:  Published February 1986
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Abstract

In vitro, neopterin, a pyrazinopyrimidine compound, is excreted by human monocytes-macrophages after induction by supernatants from activated T-lymphocytes or by recombinant γ-interferon. In vivo, it represents a noninvasive test for activation of cellular immune reactions. To evaluate the prognostic value of pretherapeutic urinary neopterin levels and of serial neopterin measurements during follow-up in women with cervical cancer, 1088 urine specimens from 186 consecutive patients were analyzed. Clinical assessments were made without knowledge of the results of neopterin assays (a “blinded” assessment). During the observation period (June 1980 to March 1984), 27 relapses, 18 metastases, and 26 deaths were seen. The prognostic significance of pretherapeutic neopterin and other possible prognostic clinical and laboratory parameters was tested by the univariate and multivariate Cox proportional hazards model using a stratification according to stage and surgical treatment. The combination of age at diagnosis, pretherapeutical hemoglobin, leukocyte count, and neopterin was found to predict survival best. On the basis of this result, risk groups were identified exhibiting markedly different survival behavior. A highly significant association was found between serial neopterin measurements and the risk for a relapse, metastasis, or death. The data suggest that urinary neopterin levels might be a useful adjuvant parameter in monitoring women with cervical cancer.

Footnotes

  • ↵1 Supported by the Austrian research funds “Zur Förderung der wissenschaftlichen Forschung,” Project No. 4905.

  • ↵2 Recipient of a postdoctoral research fellowship from the Deutsche Forschungsgemeinschaft.

  • ↵3 To whom requests for reprints should be addressed, at Institut für Medizinische Chemie, Der Universität Innsbruck, Fritz Pregl-Str. 3, A-6020 Innsbruck, Austria.

  • Received May 29, 1985.
  • Revision received August 22, 1985.
  • Revision received October 24, 1985.
  • Accepted October 25, 1985.
  • ©1986 American Association for Cancer Research.
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February 1986
Volume 46, Issue 2
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Neopterin as a Prognostic Indicator in Patients with Carcinoma of the Uterine Cervix
Gilbert J. Reibnegger, Alfred H. Bichler, Otto Dapunt, Dietmar N. Fuchs, Lothar C. Fuith, Arno Hausen, Heinz M. Hetzel, Hermann Lutz, Ernst R. Werner and Helmut Wachter
Cancer Res February 1 1986 (46) (2) 950-955;

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Neopterin as a Prognostic Indicator in Patients with Carcinoma of the Uterine Cervix
Gilbert J. Reibnegger, Alfred H. Bichler, Otto Dapunt, Dietmar N. Fuchs, Lothar C. Fuith, Arno Hausen, Heinz M. Hetzel, Hermann Lutz, Ernst R. Werner and Helmut Wachter
Cancer Res February 1 1986 (46) (2) 950-955;
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