PREDICTIVE VALUE OF URINARY NEOPTERIN IN PATIENTS WITH LUNG-CANCER

Concentrations of neopterin, which is produced by human monocytes/macr ophages when stimulated by gamma-interferon, were measured in urine sp ecimens from 72 patients with lung cancer at diagnosis. Other routine clinical and laboratory variables were concomitantly determined. Neith er neopterin nor any other laboratory variable studied showed a signif icant correlation with clinical indicators of the disease (morphologic type, tumour stage, grading, lymph node status, presence of distant m etastases). The cancer patients were followed up for up to 10 years, a nd the abilities of all variables to predict fatal outcome were assess ed. In univariate survival analyses, all clinical indicators except mo rphologic type (P = 0.86) were significant predictors of survival (P < 0.002), but of all the laboratory variables studied, only neopterin w as significantly predictive (P = 0.0013). By multivariate survival ana lysis, a combination of four variables was found to jointly predict su rvival: lymph node status (P = 0.003, multivariate model), tumour stag e (P = 0.0006), grading (P = 0.0047) and neopterin (P = 0.0047). The d ata suggest that certain aspects of immune activation may have adverse consequences for the prognosis of patients with lung cancer.