title: The Impact of the Expression Level of Intratumoral Dihydropyrimidine Dehydrogenase on Chemotherapy Sensitivity and Survival of Patients in Gastric Cancer: A Meta-Analysis.
abstract: The potential impact that the intratumoral expression level of dihydropyrimidine dehydrogenase (DPD) has on chemotherapy sensitivity and long-term survival for gastric cancer (GC) patients remains controversial; therefore, this study seeks to clarify this issue. Our meta-analysis was performed using Review Manager (RevMan) 5.3 software. In vitro drug sensitivity tests, correlation coefficients between sensitivity to 5-fluorouracil (5-FU), and expression levels of intratumoral DPD were used as effective indexes to analyse. Overall survival (OS) and progression-free survival (PFS) were used as endpoints for patient outcome, and hazard ratios (HRs) and 95% confidence intervals (CIs) were noted as measures of effect. There were 15 eligible studies including 1805 patients for the final analysis. The analysis revealed a statistically significant difference between the expression level of intratumoral DPD activity, DPD mRNA levels, and sensitivity to 5-FU in GC patients, with high expression levels of intratumoral DPD resulting in low sensitivity to 5-FU. However, no matter what therapeutic regimens were used, there was no significant difference for patient outcomes between high and low DPD expression groups, either in OS or in PFS. In conclusion, high levels of intratumoral DPD expression have a negative impact on sensitivity to 5-FU in GC patients, but no prognostic value for long-term survival was uncovered.
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Hongpeng
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Yongxi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Gao
authors.affiliation: Department of Breast Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Dehao
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Zhenning
authors.identifier: 0000-0003-0557-3097
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000235:genetics* / Q000378:metabolism; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D005472:Fluorouracil / Q000627:therapeutic use*; D015870:Gene Expression; D006801:Humans; D015552:Injections, Intralesional; D009363:Neoplasm Proteins / Q000235:genetics* / Q000378:metabolism; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D009363:Neoplasm Proteins; D012333:RNA, Messenger; D042943:Dihydrouracil Dehydrogenase (NADP); D005472:Fluorouracil