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Clinical Chemistry 45: 1998-2004, 1999;
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(Clinical Chemistry. 1999;45:1998-2004.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Neopterin Is an Independent Prognostic Variable in Females with Breast Cancer

Christian Murr1, Anton Bergant2, Martin Widschwendter2, Kurt Heim2, Hans Schröcksnadel2 and Dietmar Fuchs1,a

1 Institute for Medical Chemistry and Biochemistry, and
2 Department for Gynecology and Obstetrics, University of Innsbruck, Fritz Pregl Strasse 3, A-6020 Innsbruck, Austria.
a Author for correspondence. Fax 43-512-507-2865; e-mail Dietmar.Fuchs{at}uibk.ac.at

Background: Neopterin, produced by human monocytes/macrophages upon stimulation by interferon-{gamma}, is a sensitive marker for monitoring Th1-cell immune response in humans. In malignant diseases, the frequency of increases in neopterin in the serum and urine of patients depends on tumor stage and type.

Methods: In a retrospective study comprising 129 females with breast cancer, urinary neopterin/creatinine ratios were measured at the time of diagnosis. Tumor characteristics were determined concomitantly.

Results: Urinary neopterin was increased in 18% of the patients. It did not correlate with tumor size or lymph node status, but it was influenced by the presence of distant metastases (P <0.05) and by tumor differentiation (P = 0.01). When product-limit estimates were calculated after follow-up for up to 13 years (median follow-up, 56 months), the presence of distant metastases (P <0.001), neopterin (P <0.001), tumor size (P = 0.001), and lymph node status (P <0.01) were significant predictors of survival. By multivariate analysis, a combination of the variables presence of distant metastases (P <0.001), neopterin (P <0.01), and lymph node status (P <0.05) was found to jointly predict survival. In lymph node-negative patients without distant metastases, the relative risk of death associated with increased neopterin concentrations was 2.5 compared with patients with neopterin concentrations within the reference interval.

Conclusion: Urinary neopterin provides additional prognostic information in patients with breast cancer.




The following articles in journals at HighWire Press have cited this article:


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M. Widschwendter and U. Menon
Circulating Methylated DNA: A New Generation of Tumor Markers
Clin. Cancer Res., December 15, 2006; 12(24): 7205 - 7208.
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K. Schroecksnadel, B. Frick, and D. Fuchs
Re: Plasma Folate, Vitamin B6, Vitamin B12, Homocysteine, and Risk of Breast Cancer
J Natl Cancer Inst, July 16, 2003; 95(14): 1091 - 1091.
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H. Schennach, C. Murr, C. Larcher, W. Streif, E. Pastner, D. Zaknun, D. Schonitzer, and D. Fuchs
Neopterin Concentrations in Cord Blood: A Single-Cohort Study of Paired Samples from 541 Pregnant Women and Their Newborns
Clin. Chem., November 1, 2002; 48(11): 2059 - 2061.
[Full Text] [PDF]

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H. Schennach, C. Murr, E. Gachter, P. Mayersbach, D. Schonitzer, and D. Fuchs
Factors Influencing Serum Neopterin Concentrations in a Population of Blood Donors
Clin. Chem., April 1, 2002; 48(4): 643 - 645.
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