Levels of serum neopterin are increased in pancreatic cancer patients and correlate with the prognosis.
Neopterin has been recognized as a valid marker for cellular immune activation. Raised neopterin levels indicate the stimulation of macrophages and indirectly T-cell activation. So far no data is available on serum neopterin in pancreatic cancer patients.


METHODS
In this prospective clinical study serum neopterin values were evaluated in 83 patients with adenocarcinoma of the pancreas (PC), 47 patients with chronic pancreatitis (CP), 8 patients with cystadenocarcinoma (CA) of the pancreas and 24 healthy controls (HC).


RESULTS
Serum neopterin was significantly elevated in PC (p < 0. 05) and CA (p < 0.04) as compared to HC. There was no difference found between CP and HC. Pancreatic cancer patients with neopterin levels above 2 pmol/ml had a significantly better survival (p < 0. 05) regardless of stage. In stage III and IV (UICC) this difference was highly significant (p < 0.001). Serum levels of neopterin in resectable patients were also significantly correlated with increased survival and in multivariate analysis proved to be an independent prognostic factor. Neopterin in PC was neither correlated with sex, resectability nor with CA 19/9 and CEA.


CONCLUSIONS
Patients suffering from PC who did show activated cellular immune response reflected in elevated neopterin levels above 2 pmol/ml had a significantly better prognosis regardless of tumor stage. In advanced stages elevated neopterin concentrations were significantly associated with increased survival. Cellular immune response seems to influence survival in these advanced stages to a higher degree as expected. These findings underline the possibility for supportive immunotherapy in this patient group.
Birk
D
D
Department of General Surgery, University Ulm, Steinhövelstr.9, D-89075 Ulm, Germany.
Gansauge
F
F
Gansauge
S
S
Schwarz
A
A
Beger
H G
HG
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D002908:Chronic Disease; D003536:Cystadenocarcinoma / Q000097:blood / Q000276:immunology / Q000601:surgery; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D019798:Neopterin / Q000097:blood*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000276:immunology / Q000601:surgery; D010195:Pancreatitis / Q000097:blood; D011379:Prognosis
D014408:Biomarkers, Tumor; D019798:Neopterin