The value of urinary neopterin as an immunological parameter in patients with malignant tumors of the genitourinary tract.

In 153 patients with verified neoplasias of the genitourinary tract, urinary neopterin excretion was monitored under different conditions. As control, urinary neopterin values were taken from 208 male and 209 female volunteers. Neopterin excretion was measured by high performance liquid chromatography. Patients with early tumor stages, both with bladder tumor and carcinoma of the prostate, presented almost normal urinary neopterin levels. The difference of urinary neopterin excretion between low and high stages in bladder tumor (T0-1 versus T2-4) as well in carcinoma of the prostate (stage A-B versus stage C-D) is highly significant (p less than 0.001). In the group of patients with renal cell carcinoma we could not find any correlation between tumor stage and neopterin excretion. The basal urinary neopterin values in patients with testicle tumors were as follows: 1 of 6 patients stage-I seminomatous tumors and 2 of 4 patients with stage-I non-seminomatous tumors demonstrated elevated neopterin levels. In the higher stages all patients, in both groups, exhibited pathologically increased neopterin excretion. During therapy and follow-up: all 24 stage-I (seminomatous and non-seminomatous tumors) patients showed normal neopterin levels: 1 of 3 stage-II (non-seminomatous tumors) patients and all 5 stage-IV (seminomatous and non-seminomatous tumors) patients had elevated urinary neopterin excretion. Our experience suggests that neopterin measurements may supplement laboratory examinations in patients with malignant tumor diseases of the genitourinary tract, providing meaningful information in regard to early detection of tumor progression, tumor recurrence and follow-up.