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Histopathological response to preoperative chemotherapy including 5-fluorouracil additionally assessed by immunocytochemical and pharmacologic parameters in patients with advanced gastric cancer

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Abstract

To investigate quantitative methods for assessing the response to preoperative downstaging chemotherapy (PDC), the immunocytochemical expression of proliferating cell nuclear antigen (PCNA) and bromodexoyuridine (BrdU) as well as a pharmacologic study of the rate of thymidylate synthetase inhibition (TSIR) were studied in resected specimens obtained from patients with advanced gastric cancer. Fifty-one patients with advanced gastric cancer who received PDC (30 with 5-fluorouracil peroral administration and the other 21 with intravenous administration of 5-fluorouracil and cisplatin) were studied. The labeling index of PCNA (PCNA-LI) and BrdU were measured. The PCNA suppression (PCNA-S), which was measured by both the values of prechemotherapeutic PCNA-LI in endoscopically biopsied specimens and postchemotherapeutic PCNA-LI in resected specimens, was also examined. TSIR was measured by a protein-bound radiochemical method. We compared the above-mentioned parameters with the histopathological response to PDC according to the General Rules for Gastric Cancer Study. In the patients with peroral 5-flurorouracil, a stepwise regression analysis showed that TSIR is a significantly effective for determining the histopathological response to PDC. In the patients with 5-fluorouracil and cisplatin, PCNA-S was the most effective indicator of the histopathological response to PDC, as shown by a stepwise regression analysis. The present study thus showed that both TSIR and PCNA-S were effective additional indicators of the histopathological response to PDC.

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Authors and Affiliations

  1. Department of Surgery, Showa Univesity Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, 227, Yokohama, Japan

    Hiroshi Nakano, Kimio Namatame, Hiroyoshi Takahashi, Hitoshi Sakai, Toyohide Nakamura & Kaoru Kumada

  2. Department of Histochemistry, Showa Univesity Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, 227, Yokohama, Japan

    Takao Suzuki

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  1. Hiroshi Nakano
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  2. Kimio Namatame
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  3. Takao Suzuki
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  4. Hiroyoshi Takahashi
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  5. Hitoshi Sakai
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  6. Toyohide Nakamura
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  7. Kaoru Kumada
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Nakano, H., Namatame, K., Suzuki, T. et al. Histopathological response to preoperative chemotherapy including 5-fluorouracil additionally assessed by immunocytochemical and pharmacologic parameters in patients with advanced gastric cancer. Surg Today 26, 482–488 (1996). https://doi.org/10.1007/BF00311553

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  • DOI: https://doi.org/10.1007/BF00311553

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