Diagnostic and prognostic usefulness of N-1,N-8-diacetylspermidine and N-1,N-12-diacetylspermine in urine as novel markers of malignancy

Recently, we found N-1,N-8-diacetylspermidine (Ac(2)Spd) and N-1,N-12-diacetylspermine (Ac(2)Spm) in human urine, and noted that their amount increased significantly in patients with urogenital malignancies. Previous findings that simultaneous reference to these diacetylpolyamines is useful in distinguishing cancer patients from healthy persons were confirmed by more recent analytical data on urine samples from several cancer patients. Further examination revealed that urinary Ac(2)Spm and Ac(2)Spd tended to decrease when cancer patients were treated and entered partial remission. In cases where the Ac(2)Spm and Ac(2)Spd levels were normal or near-normal after treatments, the prognosis of the patients was generally good. In contrast, when their level remained far above the normal limits after apparently effective treatment, the prognosis of the patients was poor. When a patient is in remission for more than 3 years, urinary levels of both Ac(2)Spm and Ac(2)Spd are stabilized and stay below the normal limits, with rare exceptions. The recurrence of a cancer as well as the complication of a second one during the period of follow-up examination was accompanied by elevation of urinary diacetylpolyamines. These observations indicate that urinary Ac(2)Spm and Ac(2)Spd are useful as prognostic indicators after treatment and during follow-up examination of cancer patients.