title: Correlation between thymidine phosphorylase expression and prognosis in human renal cell carcinoma.
abstract: OBJECTIVE
  Thymidine phosphorylase (TP) is identical to platelet-derived endothelial cell growth factor (PD-ECGF) and has angiogenic activity. We examined whether TP expression in renal cell carcinoma (RCC) is associated with microvessel density as a marker of angiogenesis, clinicopathologic characteristics, and outcome.
  
  
  METHODS
  The enzymatic activity and expression of TP were examined in 18 RCCs and 19 kidney tissues not grossly involved with tumor from 24 patients with 13 paired samples and 11 unpaired samples by spectrophotometry and immunoblotting. The relationship between TP expression and microvessel density was assessed by immunohistochemistry in 133 RCCs.
  
  
  RESULTS
  The median enzymatic activity of TP in RCCs was nine fold higher than that in nonneoplastic kidney tissues (P < .001). Similar results were obtained by immunoblot analysis. According to the TP staining profile, tumors were classified as no or low, intermediate, or high TP-expressing tumors. TP positivity was significantly correlated with microvessel density. TP expression was correlated with tumor grade, but there was no significant association between TP expression and other clinicopathologic characteristics. TP expression as a prognostic variable was studied using Cox's proportional hazards model. TP overexpression was an independent prognostic factor (hazards ratio, 3.95; 95% confidence interval, 0.98 to 15.89; P = .039) as were nodal category, metastases category, tumor grade, and venous invasion.
  
  
  CONCLUSIONS
  These findings suggest that TP expression is correlated with microvessel density in RCC and is an unfavorable independent prognostic factor. The future development and characterization of TP inhibitors may provide a novel approach to the therapy of RCC.
authors.affiliation: Department of Cancer Chemotherapy, Institute for Cancer Research, Kagoshima University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Imazano
authors.forename: Y
authors.initials: Y
authors.lastname: Takebayashi
authors.forename: K
authors.initials: K
authors.lastname: Nishiyama
authors.forename: S
authors.initials: S
authors.lastname: Akiba
authors.forename: K
authors.initials: K
authors.lastname: Miyadera
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: S
authors.initials: S
authors.lastname: Akiyama
authors.forename: Y
authors.initials: Y
authors.lastname: Ohi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000201:enzymology* / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D015151:Immunoblotting; D007668:Kidney / Q000201:enzymology; D007680:Kidney Neoplasms / Q000201:enzymology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D013053:Spectrophotometry; D016019:Survival Analysis; D013939:Thymidine Phosphorylase / Q000378:metabolism*
chemical_list: D013939:Thymidine Phosphorylase