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Impact of intratumoral thymidylate synthase expression on prognosis after surgical resection for ampullary carcinoma
Author(s) -
Kato Yasushi,
Murakami Yoshiaki,
Uemura Kenichiro,
Sudo Takeshi,
Hashimoto Yasushi,
Hiyama Eiso,
Sueda Taijiro
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21879
Subject(s) - thymidylate synthase , dihydropyrimidine dehydrogenase , medicine , perineural invasion , univariate analysis , immunohistochemistry , oncology , stage (stratigraphy) , carcinoma , pathology , cancer , multivariate analysis , cancer research , fluorouracil , biology , paleontology
Background and Objectives This study evaluated possible prognostic value of expression level of intratumoral thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and orotate phosphoribosyltransferase (OPRT) in patients with resected ampullary carcinoma. Methods Immunohistochemical staining evaluated intratumoral TS, DPD, and OPRT expression in 52 surgical specimens of patients with ampullary carcinoma. Relationships between clinicopathological factors including intratumoral TS, DPD, or OPRT expressions and survival was evaluated by univariate and multivariate analysis. Results High intratumoral DPD, OPRT, and TS expressions were found in 19 (37%), 30 (58%), and 23 (44%) of cases, respectively. Patients with high TS expression had more advanced‐stage disease than those with low TS expression. Univariate analysis revealed that gender, perineural invasion, lymph node status, UICC pT factor, UICC stage, OPRT expression, and TS expression correlated significantly ( P < 0.05) with disease‐specific survival. Only perineural invasion ( P = 0.043) and TS expression ( P = 0.019) were independent prognostic factors of disease‐specific survival by multivariate survival analysis. Five‐year disease‐specific survival rates of patients with high and low intratumoral TS expression were 47% and 91%, respectively. Conclusions Intratumoral TS expression level may be a potent predictor of prognosis after surgical resection for ampullary carcinoma. J. Surg. Oncol. 2011;103:663–668. © 2011 Wiley‐Liss, Inc.