title: Where should the specimen be excised for the chemosensitivity of colorectal cancer to 5-fluorouracil?
abstract: OBJECTIVE
  The aim of this study was to reveal the relationship between the expression of dihydropyrimidine dehydrogenase (DPD) and thymidylate synthase (TS) in normal tissue, lymph nodes or tumors and as a prognostic indicator in T3 rectal carcinoma.
  
  
  METHODS
  This study was prospectively conducted on 20 consecutive patients with T3 rectal cancer for whom surgically curative resection was performed between 2000 and 2002. Specimens were obtained from normal tissue more than 10cm away from the tumor, the lymph node in the mesorectum, and tumor tissue during surgery. The specimens were promptly frozen at -80 degrees C for DPD and TS value assaying.
  
  
  RESULTS
  DPD expression in the tumor did not correlate with postoperative recurrence. However, there was a strong relationship between recurrence and expression of TS at the invasive front of the tumor or in the lateral border of the tumor. Particularly, TS expression at the invasive front of the tumor strongly correlated with recurrence (p = 0.002).
  
  
  CONCLUSIONS
  For the chemosensitivity of colorectal cancer to 5-Fluorouracil, the specimen should be excised from the invasive front of the tumor, and TS expression should be evaluated in it.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Nishi-Shinbashi 3-25-8, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Ushigome
authors.forename: Hidejiro
authors.initials: H
authors.lastname: Kawahara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000378:metabolism; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000201:enzymology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000201:enzymology / Q000473:pathology / Q000601:surgery*; D013940:Thymidylate Synthase / Q000378:metabolism
chemical_list: D000964:Antimetabolites, Antineoplastic; D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase; D005472:Fluorouracil