title: Impact of intratumoral thymidylate synthase expression on prognosis after surgical resection for ampullary carcinoma.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. yasshii777@yahoo.co.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kato
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sudo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Eiso
authors.initials: E
authors.lastname: Hiyama
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002277:Carcinoma / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009962:Orotate Phosphoribosyltransferase / Q000378:metabolism; D011379:Prognosis; D015996:Survival Rate; D013940:Thymidylate Synthase / Q000378:metabolism*
chemical_list: D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase; D009962:Orotate Phosphoribosyltransferase