Neopterin can be used as an objective index of disease activity and response of therapy. In malignant diseases, the degree of neopterin elevations is a measure of clinical activity, and serves as a measure of extent of disease in some tumors.
Since
the
analysis of urinary neopterin in gastrointestinal cancer patients is important in diagnosing malignancy, a method has been developed for its rapid and sensitive separation and quantitation using high performance liquid chromatography(HPLC) on
reverse
phase. The aim of this study was to evaluate the correlation of the clinical and pathologic stage in gastric cancer and the neopterin level. Using HPLC method, urinary levels of neopterin related to creatinine were determined for 40 gastric
cancer
patients(December, 1993~September, 1994), The samples were the patient's first morning urine(1 ml) and added 25 mg of disodium ethylenediamine tetracetate and stored at -20℃ in the dark state.
Then samples were preparated with 1%, I2, 2% KI and ascorbic acid, after then centrifuged at 3,000 rpm for 15 minutes. The supernatant was injected into HPLC. The other method was the use of commercially available Sep-Pak C18 cartridges(Waters
Asso).
With this method, urinary neopterin level was measured in gastric cancer patients with stage Ⅳand recurrence. The data was analysed with student's t-test and it was statistically significant when p value was lower than 0.05. The results were as
follows; in TNM classification, the neopterin/Cr. level was positively correlated with advanced stage(p<0.05). In WHO classification, the neopterin/Cr. level of poorly differentiated group was higher than well differentiated group(p<0.05). In
Ming's
classification urinary neopterin level of infiltrative type group was higher than that of expanding type group(p<0.05). In Lauren's classification the neopterin/Cr. level of diffuse type group was higher than that of intestinal type
group(p<0.05).
In
conclusion, there was a positive correlation between neopterin/creatinine ratio and the stage of gastric cancer and the severity of gastric cancer(Severity means advanced state in pathologic classification. For example, stage Ⅱthan I, stage
Ⅲthan
Ⅱ,
stage Ⅳ than stage Ⅲin TNM classification, poorly differentiate than well differentiated in WHO classification, infiltrative type than expanding type in Ming's classification, diffuse type than intestinal type in Lauren's classification). So
urinary
neopterin levels were closely related to the extent of the lesion and severity of the disease10. 13. 16)
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