Dihydropyrimidine dehydrogenase expression in preoperative biopsy and surgically resected specimens of gastric carcinoma.
OBJECTIVE
5-Fluorouracil (5-FU) is most commonly used to treat patients with gastrointestinal neoplasms, including gastric carcinoma. Dihydroxypyrimidine dehydrogenase (DPD), an enzyme involved in metabolism of 5-FU, is a key factor determining the sensitivity of the tumors to 5-FU. Particularly when preoperative chemotherapy based on 5-FU is attempted, it is critical to know in advance how much DPD the tumor expresses. We investigated preoperative biopsy and surgically resected specimens of gastric carcinomas immunohistochemically for the expression of DPD.


METHODS
The study group comprised 55 advanced gastric carcinoma patients who had undergone surgery. Sections of the biopsy and resected specimens were immunostained with anti-DPD polyclonal antibody. DPD immunoreactivity was classified into four groups based on staining intensity expressed as DPD score. We compared the DPD scores of the biopsy specimens with those of the resected specimens. The possible associations between DPD score and survival rate or clinicopathological parameters, including prognostic factors, were also analyzed.


RESULTS
The DPD scores of the biopsy specimens correlated with those of the resected specimens (kappa=0.456). In agreement with previous reports, the DPD scores of the gastric carcinomas were not associated with prognosis or with any clinicopathological factor.


CONCLUSIONS
It is considered that immunohistochemical analysis of DPD expression in gastric carcinoma using biopsied tissue is a technically feasible method to assess the expression of DPD in the tumor prior to surgical resection.
Nozawa
Hiroaki
H
Department of Surgery, Tokyo Postal Services Agency Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan. NOZAWAH-SUR@h.u-tokyo.ac.jp
Tsukui
Hajime
H
Nishida
Koichiro
K
Yakumaru
Kazuhiro
K
Nagawa
Hirokazu
H
Sekikawa
Takayoshi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D042943:Dihydrouracil Dehydrogenase (NADP); D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010088:Oxidoreductases / Q000032:analysis*; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology
D010088:Oxidoreductases; D042943:Dihydrouracil Dehydrogenase (NADP)