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Published on: February 5, 2018
Dihydropyrimidine dehydrogenase expression in preoperative biopsy and surgically resected specimens of gastric
Hiroaki Nozawa1, Hajime Tsukui, Koichiro Nishida
1Department of Surgery, Tokyo Postal Services Agency Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo 102-8798, Japan. NOZAWAH-SUR@h.u-tokyo.ac.jp
Purpose:
5-Fluorouracil (5-FU) is most commonly used to treat patients with gastrointestinal neoplasms, including gastric carcinoma. Dihydroxypyrimidine dehydrogenase (DPD), an enzyme involved in metabolism of 5-FU, is a key factor determining the sensitivity of the tumors to 5-FU. Particularly when preoperative chemotherapy based on 5-FU is attempted, it is critical to know in advance how much DPD the tumor expresses. We investigated preoperative biopsy and surgically resected specimens of gastric carcinomas immunohistochemically for the expression of DPD.
Methods:
The study group comprised 55 advanced gastric carcinoma patients who had undergone surgery. Sections of the biopsy and resected specimens were immunostained with anti-DPD polyclonal antibody. DPD immunoreactivity was classified into four groups based on staining intensity expressed as DPD score. We compared the DPD scores of the biopsy specimens with those of the resected specimens. The possible associations between DPD score and survival rate or clinicopathological parameters, including prognostic factors, were also analyzed.
Results:
The DPD scores of the biopsy specimens correlated with those of the resected specimens (kappa=0.456). In agreement with previous reports, the DPD scores of the gastric carcinomas were not associated with prognosis or with any clinicopathological factor.
Conclusions:
It is considered that immunohistochemical analysis of DPD expression in gastric carcinoma using biopsied tissue is a technically feasible method to assess the expression of DPD in the tumor prior to surgical resection.
