Rate of Thymidylate Synthetase Inhibition in Gastric Cancer Tissue: Prognostic Indicators in Advanced Gastric Cancer Patients with Preoperative Chemotherapy

Abstract

Fifty-one resected advanced gastric cancer patients who had preoperative chemotherapies, consisting of oral administration of 5-fluorouracil (5-FU) and 5-FU/ cisplatin intravenous administration, were included in the present study. The rate of thymidylate synthetase inhibition (TSIR) was measured in resected tissues. Proliferating cell nuclear antigen expression (PCNA-S) and the rate of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling expression (TUNEL-I) were also investigated in gastric cancer tissues obtained before and after chemotherapy. The aim of the present study was to examine whether these parameters were reliable prognostic indicators in these patients. Five-year survival analysis showed that a higher value of TSIR significantly predicted a better prognosis. A multiple regression analysis showed that TSIR and the conclusive stage were significant predictive indicators for prognosis in these patients. In curatively resected patients, TSIR was the only significant prognostic indicator. Therefore, TSIR in gastric cancer tissue is a useful indicator for predicting the efficacy of preoperative chemotherapy.