Expression of thymidylate synthase and dihydropyrimidine dehydrogenase in adenoid cystic carcinoma of the head and neck: Correlation with clinical outcome

• Published in: Oral oncology 2007-08, Vol.43 (7), p.662-669
• Main Authors: Chikamatsu, Kazuaki, Shino, Masato, Sakakura, Koichi, Nakajima, Kyoko, Sakurai, Tsutomu, Miyashita, Motoaki, Furuya, Nobuhiko
• Format: Article
• Language: English
• Subjects: Adenoic cystic carcinoma; Adult; Aged; Biological and medical sciences; Biomarkers, Tumor - analysis; Carcinoma, Adenoid Cystic - enzymology; Carcinoma, Adenoid Cystic - metabolism; Carcinoma, Adenoid Cystic - pathology; Dihydropyrimidine dehydrogenase; Dihydrouracil Dehydrogenase (NADP) - metabolism; Female; Head and Neck Neoplasms - enzymology; Head and Neck Neoplasms - metabolism; Head and Neck Neoplasms - pathology; Hematology, Oncology and Palliative Medicine; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Otolaryngology; Otorhinolaryngology. Stomatology; p53; Prognostic factor; Thymidylate synthase; Thymidylate Synthase - metabolism; Tumor Suppressor Protein p53; Tumors
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2006.08.005

Summary The purpose of this study was to estimate the possibility of using thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and p53 as predictive values of clinical outcome in adenoid cystic carcinoma (ACC). The expressions of TS, DPD, and p53 were examined with immunohistochemistry in 27 ACC patients, and the association with clinicopathological factors was determined. Cases with high DPD expression had significantly higher distant metastasis rates compared to those with low DPD expression ( p = 0.001), whereas neither TS nor p53 expression showed any significant correlation to clinicopathological factors. Interestingly, six of 14 early-stage patients had distant metastases and all of their tumors showed high DPD expression. Kaplan–Meier analysis revealed that a solid histological pattern and distant metastasis correlated with a poor prognosis. In early-stage patients, whose tumor was completely resected, those with high TS or DPD expression had a worse prognosis compared to those with low expression, but the difference did not reach statistical significance (TS, p = 0.178; DPD, p = 0.251). Our results suggest that assessment of DPD expression in ACC may be a useful tool in determining the mode of treatment as well as evaluating clinical outcome.