Prognostic significance of the thymidine phosphorylase/dihydropyrimidine dehydrogenase ratio in invasive cervical cancer

Objective: In this study, we measured both thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) levels, and then determined the TP/DPD ratios, in a number of invasive cervical cancers. Our aim was to investigate the association between these values and the clinicopathological features of invasive cervical cancer, including patient prognosis. Study design: Using enzyme-linked immunosorbent assays, the TP and DPD activities were quantitatively measured in 51 patients with cervical cancer who had also undergone a radical hysterectomy. Results: The TP, DPD and TP/DPD values in squamous cell carcinoma (SCC) were found to be significantly higher than the levels in non-SCC. Furthermore, in a SCC subgroup, the TP/DPD levels were significantly higher in cases where parametrial invasion was evident, and in a non-SCC subgroup, these levels were also significantly higher in cases with deep stromal invasion, lymph-vascular space invasion, large tumor size and parametrial invasion. The disease-free survival rate is shown to be significantly higher in patients with low TP/DPD levels indicating that this ratio may be associated with both the progression and recurrence of invasive cervical cancer. Conclusion: TP/DPD ratios may be associated with both the progression and recurrence of invasive cervical cancer.