title: Urinary neopterin in patients with liver tumors.
abstract: OBJECTIVE
  Primary and secondary liver tumors are associated with poor prognosis. Neopterin is an indicator of systemic immune activation, and increased neopterin concentrations have been associated with poor prognosis in a wide range of malignant tumors.
  
  
  METHODS
  Urinary neopterin was determined by high-performance liquid chromatography in 154 patients with primary and secondary liver tumors. The survival of different groups of patients was compared by log-rank test, and Cox regression was used for multivariate analysis.
  
  
  RESULTS
  Urinary neopterin was significantly increased in patients compared to controls. A statistically significant correlation was observed between urinary neopterin and age of the patients, hemoglobin concentration, mean erythrocyte volume and peripheral blood leukocyte or platelet count. In univariate analysis, urinary neopterin below 214 micromol/mol creatinine, peripheral blood leukocytes below 8 x 10(9)/L, hemoglobin equal to or above 125 g/L, no extrahepatic tumor, stage of liver involvement, and colorectal, breast or ovarian primary were significant prognostic factors for survival. In multivariate analysis, Bengtsson stage, presence of extrahepatic involvement, primary other than colorectal, breast or ovarian carcinoma, peripheral blood leukocyte count and urinary neopterin were independent prognostic factors. Increased urinary neopterin during and at the end of follow-up was also associated with poor prognosis.
  
  
  CONCLUSIONS
  Urinary neopterin is increased in patients with liver tumors. Neopterin is an independent prognostic indicator in patients with liver tumors along with Bengtsson stage, presence of extrahepatic disease, primary site and peripheral blood leukocyte count.
authors.affiliation: Department of Oncology and Radiotherapy, Charles University Medical School Teaching Hospital, Hradec Králové, Czech Republic. melichar@fnhk.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Dagmar
authors.initials: D
authors.lastname: Solichová
authors.forename: Iveta
authors.initials: I
authors.lastname: Svobodová
authors.forename: Lubor
authors.initials: L
authors.lastname: Urbánek
authors.forename: Pavel
authors.initials: P
authors.lastname: Veselý
authors.forename: Karolina
authors.initials: K
authors.lastname: Melicharová
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000652:urine*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019798:Neopterin / Q000652:urine*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D006454:Hemoglobins; D019798:Neopterin