Review Article

The Impact of the Expression Level of Intratumoral Dihydropyrimidine Dehydrogenase on Chemotherapy Sensitivity and Survival of Patients in Gastric Cancer: A Meta-Analysis

Table 1

Basic characteristics of eligible studies.

First authorYearCountrySample sizeDisease stageDrugsMethodCut-off valueHR for OS
(95% CI)
HR for PFS
(95% CI)
Correlation coefficientDrug sensitivity testFollow-up times

Ichikawa [31]2006Japan59LateS-1RT-PCRMedian1.08 (0.97 to 1.21)2 years
Jeung [32]2011Korea75LateS-1RT-PCRMedian0.97 (0.47 to 2.00)1.1 (0.68 to 1.78)4 years
Koizumi [33]2010Japan65LateS-1RT-PCR:
1.9 (0.88 to 4.09)3 years
Matsubara [19]2008Japan137Locally advanced or lateS-1, 5-FU, cisplatin + S-1 or irinotecanRT-PCR: MA: 2.04 (1.37 to 3.02)7 years
Sasako [34]2015Japan401Stage II, III, R0 resectionS-1RT-PCR33.3rd, 50th, or 66.7th percentilesMA: 0.66 (0.44 to 1.01)
(33.3rd)
5 years
Yamada [35]2013Japan304Late5FU, cisplatin + irinotecan, S-1RT-PCRMedianAll: 0.95 (0.75 to 1.20);
S-1: 0.85 (0.56 to 1.29)
1.00 (0.80 to 1.26) (all);
0.93 (0.63 to 1.38) (S-1)
3 years
Tsuburaya [40]2016Japan106Locally advanced or lateS-1 or S-1 + irinotecanRT-PCRMedianMA: 1.33 (0.87 to 2.02)3 years
Hisamitsu [13]2004Japan111T3 stage, R0 resectionUFTIHCPercentage: 5%1.03 (0.27 to 3.98)5 years
Miyamoto [36]2000Japan41LateS-1IHCIntensity
Negative 0,1
Positive 2,3
0.86 (0.27 to 2.73)2 years
Oeda [37]2006Japan221Stages I to IVUFT, MMC + 5-FUIHCProportion: 10%1.44 (0.86 to 2.40)5 years
Fakhrejahani [38]2007Japan87Stages I to IV5-FURT-PCR−0.401HDRA
Inada [20]2000Japan34Locally advanced5-FUEnzymatic assay−0.152HDRA
Ishikawa [39]2000Japan41Locally advanced5-FURT-PCR and enzymatic assay−0.41 (mRNA)
−0.48 (activity)
MTT assay
Terashima [15]2003Japan67Stages I to IV5-FUEnzymatic assay−0.351ATP assay
Fujiwara [41]2002Japan58Stages I to IV5-FURT-PCR−0.458ATP assay

Note. 5-FU: 5-fluorouracil; UFT: uracil/tegafur 4 : 1; MMC: mitomycin C; IHC: immunohistochemistry; RT-PCR: reverse transcriptase polymerase chain reaction; HR: hazard ratio; OS: overall survival; CI: confidence interval; PFS: progression free survival; MA: multivariate analysis; HDRA: histoculture drug response assay; MTT: tetrazolium-based colorimetric assay; : maximal method.
There was a patient with triple advanced gastric cancer. Percentage of stained cells to the total tumor cells. The intensity of immunohistochemistry staining. Proportion of cancer cells that were positively stained.