title: Prognostic Value of Excision Repair Cross-Complementing Gene 1, Dihydropyrimidine Dehydrogenase, and Human Equilibrative Nucleotide Transporter 1 Expression and Their Implications for Adjuvant Treatment in Patients With Ampullary Carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to characterize the intratumoral expression profiles of excision repair cross-complementing gene 1 (ERCC1), dihydropyrimidine dehydrogenase (DPD), and human equilibrative nucleotide transporter 1 (hENT1) in ampullary carcinomas (ACs) to evaluate their prognostic values and better tailor adjuvant chemotherapy for individual patients with AC after surgery.
  
  
  METHODS
  This study included 49 patients with AC who underwent a curative pancreaticoduodenectomy. Various clinicopathological factors, including ERCC1, DPD, and hENT1, were analyzed in relation to postoperative disease recurrence and the patients' survival.
  
  
  RESULTS
  The median recurrence-free survival and overall survival were 24.5 months and 32.4 months, respectively. Multivariate Cox regression analysis of recurrence-free survival identified a DPD expression (hazard ratio [HR], 8.18; 95% confidence interval [CI], 2.00-34.8; P = 0.003) and combined ERCC1/DPD expression (HR, 134.8; 95% CI, 11.8-1920; P < 0.001) as independent predictors of disease recurrence. Multivariate Cox regression analysis of overall survival also identified a DPD expression (HR, 8.48; 95% CI, 1.71-46.3; P = 0.008) and combined ERCC1/ DPD expression (HR, 135.6; 95% CI, 11.8-1940; P < 0.001) as independent predictors of survival.
  
  
  CONCLUSIONS
  The DPD and ERCC1 expression profile could potentially serve as a useful prognostic biomarker and therapeutic target for surgically resected patients with AC.
authors.affiliation: From the Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Kawabata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kidani
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000201:enzymology* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003138:Common Bile Duct Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D004268:DNA-Binding Proteins / Q000032:analysis*; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000032:analysis*; D018450:Disease Progression; D018572:Disease-Free Survival; D004720:Endonucleases / Q000032:analysis*; D033721:Equilibrative Nucleoside Transporter 1 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D033721:Equilibrative Nucleoside Transporter 1; C438649:SLC29A1 protein, human; D042943:Dihydrouracil Dehydrogenase (NADP); C071447:ERCC1 protein, human; D004720:Endonucleases