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World J Gastroenterol. Oct 7, 2007; 13(37): 5030-5034
Published online Oct 7, 2007. doi: 10.3748/wjg.v13.i37.5030
Thymidylate synthase and thymidine phosphorylase gene expression as predictive parameters for the efficacy of 5-fluorouraci-based adjuvant chemotherapy for gastric cancer
Dong Hua, Zhao-Hui Huang, Yong Mao, Jian-Zhong Deng
Dong Hua, Zhao-Hui Huang, Yong Mao, Jian-Zhong Deng, Oncology Institute of Wuxi, the Fourth Affiliated Hospital of Suzhou University, Wuxi 214062, Jiangsu Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Zhao-Hui Huang, Oncology Institute of Wuxi, The Fourth Affiliated Hospital of Suzhou University, 200 Huihe Road, Wuxi 214062, Jiangsu Province, China. hzhwxsy@yahoo.com.cn
Telephone: +86-510-88683506 Fax: +86-510-88683507
Received: May 27, 2007
Revised: July 28, 2007
Accepted: July 31, 2007
Published online: October 7, 2007
Abstract

AIM: To investigate the prognostic role of thymidylate synthase (TS) and thymidine phosphorylase (TP) mRNA levels in T3 or T4 gastric cancer treated with 5-fluorouraci-based adjuvant chemotherapy.

METHODS: Fifty-one patients with T3 or T4 gastric cancer received systemic 5-fluorouraci-based adjuvant chemotherapy, and intratumoral expression of TS and TP in 51 gastric cancer tissue samples was tested by real-time quantitative PCR.

RESULTS: The median disease-free survival (DFS) time was 10.2 mo in the patients. There were no significant differences in DFS between the groups with high and low levels of TP. However, the group with low level of TS had a longer DFS (14.4 mo vs 8.3 mo, P = 0.017). The median overall survival (OS) time was 18.5 mo, and there were significant differences in OS between the groups with high and low levels of TS or TP (for TS, 17.0 mo vs 21.3 mo, P = 0.010; for TP, 16.6 mo vs 22.5 mo, P = 0.009). Moreover, the coupled low expression of these two genes was strongly associated with a longer survival time of patients as compared with that of a single gene.

CONCLUSION: Expression of TS and TP mRNA is a useful predictive parameter for the survival of postoperative gastric cancer patients after 5-fluorouracil-based adjuvant chemotherapy.

Keywords: 5-fluorouracil; Gastric cancer; Thymidine phosphorylase; Thymidylate synthase