H. Hetzel

Measurement of urinary neopterin in normal pregnant and non-pregnant women and in women with benign and malignant genital tract neoplasms

SummaryUrinary neopterin was measured in healthy women (n = 209) and men (n = 208), in patients with benign gynecological tumors (n = 53), in women with precancerous lesions of the cervix and the endometrium (n = 24) and in women with cancer of the genital tract (n = 108). In addition urinary neopterin measurements were made in 109 pregnant women and 20 women in the puerperium. No significant difference was found between mean neopterin values in patients with benign gynecological tumors, in women with precancerous lesions and in healthy women. Patients with cancer had significantly higher mean urinary neopterin levels than the control group. Raised neopterin levels were found in 56% of patients with genital tract cancer, the figures varying between 93% for ovarian cancer and 47% for cancer of the cervix. Some of the cancer patients had serial urinary neopterin measurements and in about 80% there was some relation between urinary neopterin values and clinical progress as judged clinically and radiologically, the best agreement existing in patients with ovarian cancer.Significantly higher mean neopterin values were found during normal pregnancy and in the early puerperium than in non-pregnant healthy controls.Raised urinary neopterin excretion may be due to enhanced cell proliferation and alloantigenic activation of T-lymphocytes.

Urinary neopterine excretion in patients with genital cancer

Urinary neopterine values in 96 healthy women were compared with those in a group of 63 patients with cancer of the genitals who had not yet undergone treatment. Significantly higher median neopterine levels were found in the patients with carcinoma (p less than 0.001). In the 63 cancer patients who had not yet been treated, the diagnosis was made correctly in 65% of the cases by monitoring neopterine levels. In the follow-up of 72 patients with cancer of the genitals in 74% the neopterine values corresponded with the clinico-roentgenological findings. In 22%, false positive neopterine values (no recurrence of the tumor), and in 4% false negative values (recurrence, or progression of the carcinoma) were observed. These results confirm previous reports concerning the significance of pteridine excretion in patients with cancer. However, more investigations have to be performed to establish the value of neopterine sampling in monitoring patients with malignant tumors.

Urinary neopterin excretion in patients with uterine sarcomas.

Neopterin, a pyrazinopyrimidine compound, is a marker of activation of cell‐mediated immunity. Urinary neopterin concentrations were measured in a total of 44 patients with uterine sarcomas. Pretherapeutic neopterin excretions were elevated in 78% (14/18). The mean neopterin concentration of patients with sarcomas was significantly higher (P < 0.0001) than that obtained in women with benign myomas and healthy controls. Furthermore, a significant correlation of normal or raised neopterin concentrations with the clinical course of disease was found. These data suggest that urinary neopterin measurement might be a useful immunologic marker for women with uterine sarcomas.

Photodynamic therapy in patients with recurrent gynecological carcinomas

Patients with recurrent gynecological carcinomas have a poor prognosis with a median survival time of 3 - 6 months. Four patients with recurrent vulva carcinomas, one patient with a recurrent breast cancer, and one with a recurrent cervical carcinoma underwent PDT after parenteral or topical sensitization with Photosan 3. Of those patients two women made a complete recovery with no evidence of disease 27 and 24 months after. One patient responded partially with two recurrences which were retreated twice after topical sensitization, she has survived 16 months. The remaining patients showed partial response and died 3 and 8 months after PDT. The energy delivered by an argon-dye-laser ranged between 225 and 750 J/cm2. Photosan 3 was given intravenously at a dose of 2.5 mg/kg body weight and was tolerated without any allergic reaction. A response rate of nearly 50% in recurrent gynecological malignancies encourages us to pursue PDT in gynecological diseases.

Combination chemotherapy with epirubicin and cisplatin in ovarian carcinoma

SummaryCombination chemotherapy with epirubicin-cisplatin was employed after surgical treatment in 67 women with ovarian carcinoma. 50 mg/m2 of epirubicin and cisplatin each were administered at monthly intervals. The response rate was correlated with the clinical stage and the residual disease. Tumor regression (CR+PR) was observed in 63.6% of patients with stage III disease, and in 50% of those with stage IV disease. Furthermore, complete or partial responses were obtained in 86.4% of patients with a residual deposit of 2–5 cm, and in 33.3% of women with a residual deposit exceeding 5 cm in diameter. Anemia occurred in 47.8%, leukopenia in 43.3%, and thrombocytopenia in 4.5% of the patients. No cardiotoxicity was recorded.

Die klinische Bedeutung des Neopterin als Tumormarker

Neopterin wird in Zellen von Wirbeltieren aus Guanosintriphosphat synthetisiert. Wir konnten 1979 zeigen, das Neopterin im Harn von Patienten mit malignen Erkrankungen und viralen Infekten erhoht ist (1).

Alpha-Interferon-und Retinoidtherapie bei Patientinnen mit Ovarialkarzinomen

Interferone sind Glykoproteine, die neben der Virusreplikation auch das Wachstum bestimmter benigner und maligner Zellen hemmen. In der vorliegenden Untersuchung wurden die Effizienz und das Ausmag der Nebenwirkungen einer vierw6chigen Kombinationstherapie von Alpha-Interferon (4 Mio. Einheiten pro Tag i.m.) und Retinoid (30 mg Etretinat pro Tag oral) fiberprtift. Der Grund ftir die Zugabe yon Retinoid lag in tier Tatsache, dab diese Kombination in vitro eine synergistische Hemmung des Wachstums yon Mammakarzinomzellen gezeigt hatte.

Estimation of Cardiotoxicity of Epirubicin-Cisplatin by Determination of Myoglobin

Serum myoglobin was determined in 29 patients during a total of 46 cycles of treatment with epirubicin-cisplatin. Statistical evaluation showed highly significant correlations between the myoglobin values and the age of the patients and the cumulative dose of the cytostatic agents applied.