Neopterin--a potential factor for differentiation between pancreatic cancer and chronic pancreatitis

Pancreatic cancer constitutes a difficult diagnostic and therapeutic problem. It remains the fourth cause of death among gastrointestinal malignancies. The present study aimed to investigate whether neopterin can be used as a significant marker in pancreatic cancer and to establish any possible relationships between serum neopterin levels and the differentiation between chronic pancreatitis, pancreatic cancer, and acute pancreatitis.

The research was done on a group of 65 patients with a diagnosed pancreatic tumor and on a group of 21 patients with a diagnosed acute pancreatitis. Serum neopterin concentration was determined in all patients on the first day of hospitalization.

Based on intraoperative and postoperative histopathological findings, pancreatic cancer was diagnosed in 42 patients and chronic pancreatitis in 23 patients. Neopterin concentrations in pancreatic cancer patients, chronic pancreatitis patients, and acute pancreatitis patients were 13.01-29.64 nmol/L (mean 18.16), 0.95-11.81 nmol/L (mean 6.52), and 9.64-25.0 nmol/L (mean 13.61), respectively. Mean neopterin levels in pancreatic cancer and acute pancreatitis patients were higher than the accepted norm (norm<10 nmol/L). Serum neopterin concentrations in patients with chronic pancreatitis remained within the norm.

In our opinion, neopterin might be a promising factor of differentiation between pancreatic tumors. However, the use of neopterin as a nonspecific tumor marker requires further studies.