gms | German Medical Science

Introduction: Thymidylatsynthase is an enzyme for DNA-synthesis and the target for 5-fluorouracil whereas cyclin-D1 plays a critical role in the progression of cells through the G1 phase of the cell-cycle. There is evidence that expression of these markers may predict the outcome of patients with gastric cancer. The aim of this study was to examine the prognostic value of thymidylatsynthase and cyclin-D1 protein expression in patients with gastric cancers

Material and methods: Thymidylatsynthase and cyclin-D1 protein expression from 120 patients with UICC stage I - IV gastric cancer was analyzed by immunhistochemistry in paraffin-embedded primary tumor specimens. Immunhistochemical evaluation was performed by visual grading system based on the intensity of staining (0=no staining, 1=faintly perceptible, 2=moderate, 3=strong). According to staining intensity, cancers were classified as strong (3) and other (0+1+2) expressing tumors.

Results: Minor- and strong thymidylatsynthase immunoreactivity was present in 107 (89%) and 13 (11%) of cancers, respectively. Minor- and strong cyclin-D1 immunoreactivity was present in 109 (91%) and 11 (9%) of the cancers, respectively. Tumor stage and recurrence were associated with overall-survival. Patients with strong- (n=13) thymidylatsynthase expressing tumors had a worse overall-survival than patients with minor- (n=109) thymidylatsynthase expressing gastric cancers (p=0.012). No difference in overall-survival was seen between patients with strong- and minor- cyclin-D1 expressing cancers.

Conclusion: Thymidylatsynthase may be helpful as a prognostic marker in gastric cancer. Overall survival for patients with minor TS expressing in gastric cancer seems to be better than for those with strong TS expressing tumors.