Increased urinary polyamine excretion in unselected cancer patients related to host factors

Unselected patients with solid malignant tumours were investigated in order to determine whether they displayed elevated urinary excretion of polyamines; and if so, whether polyamine excretion in such patients predicts disease progression, or is secondary to host and systemic factors. Thirty-eight male and female patients with generalized solid, mainly gastrointestinal, malignant tumours were investigated. Ten male patients operated on for infrarenal aortic aneurysms and 15 otherwise healthy male and female patients hospitalized for minor surgical procedures served as reference patients, representing individuals with and without metabolic stress. Urine samples were collected from all patients during 24 h for measurement of both total and individual excretion of polyamines during three consecutive days. Polyamine excretion was not significantly increased in cancer patients when compared by analysis of variance among the three patient groups. However, polyamine excretion was significantly elevated in both cancer and stressed, non-cancer patients compared with patients without stress (p < 0.05). A multivariate analysis indicated that plasma protein and albumin concentrations, abnormal liver function tests and liver metastasis predicted variation in polyamine excretion in cancer patients (p < 0.01), but this was unrelated to survival. Our results demonstrate that increased polyamine excretion in cancer patients is related more to host factors than to tumour growth itself.