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Impact of intratumoral thymidylate synthase expression on prognosis after surgical resection for ampullary carcinoma

Authors

  • Yasushi Kato MD,

    Corresponding author
    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
    • Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Fax: +81-82-257-5219.
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  • Yoshiaki Murakami MD,

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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  • Kenichiro Uemura MD,

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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  • Takeshi Sudo MD,

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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  • Yasushi Hashimoto MD,

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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  • Eiso Hiyama MD,

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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  • Taijiro Sueda MD

    1. Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Abstract

Background and Objectives

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. J. Surg. Oncol. 2011;103:663–668. © 2011 Wiley-Liss, Inc.

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