title: Low dihydropyrimidine dehydrogenase correlates with prolonged survival in patients with lung adenocarcinoma treated with 5-fluorouracil.
abstract: BACKGROUND
  The enzyme dihydropyrimidine dehydrogenase (DPD) is involved in the metabolism of 5-fluorouracil (5-FU). The aim of this study was to clarify the correlation between the expression of DPD and the efficacy of 5-FU therapy in patients with lung adenocarcinoma (AD).
  
  
  METHODS
  We examined surgically resected specimens from 90 stage I to IIIA patients with lung ADs to determine the level of intra-tumoral DPD mRNA.
  
  
  RESULTS
  Administration of 5-FU improved the prognosis of patients with low DPD-expressing tumors, whereas it did not do so for patients with high DPD expressing tumors. Patients with low DPD-expressing tumors administered with 5-FU had a significantly better prognosis than those who underwent surgery alone. A Cox proportional hazards regression model revealed that administration of 5-FU was an independent variable to predict prognosis in patients with low DPD-expressing tumors.
  
  
  CONCLUSIONS
  Quantification of DPD mRNA levels is useful for determining the subgroup of lung AD patients who would benefit most from 5-FU after surgery.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita-city, Osaka 565-0871, Japan. yshintani@thoracic.med.osaka-u.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Funakoshi
authors.forename: Akihide
authors.initials: A
authors.lastname: Matsumura
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ohta
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000096:biosynthesis*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D013940:Thymidylate Synthase / Q000096:biosynthesis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase; D005472:Fluorouracil