ABSTRACT
Objective To investigate the expression of thymidylate synthase (TS) in bladder urothelial carcinoma(BUC) and its clinical significance, and to evaluate its prognostic value, thus to help predict the prognosis and choose therapy protocal. Methods The expression of TS was assessed by immunohistochemistry in 54 BUC and 15 normal bladder specimens, and all these clinical data were retrospectively analyzed after surgery. Expression of TS,clinicopathologic findings and two prognostic variances (relapse-free survival (RFS) and overall survival (OS)) were determined. The prognostic value of TS was estimated by survival curve and Cox proportional hazards model. Results Immunohistochemistry showed that 25 of 54 BUC cases (46. 30%) had high TS expression. In these cases,there was 29. 41%o (5/17) for G1 ,46. 43% (13/28) for G2,77. 78% (7/9) for G3 ;21.43% (3/14) for Ta, 26. 32% (5/19) for T1, 86. 67% ( 13/15 ) for T2,66.67% (2/3) for T3,66.67% (2/3) for T4. Expression of TS was positively associated with the grade and stage of carcinorma ( Kruskal - Wallis H, P = 0. 0 3 and P ＜ 0. 0 0 1 ). The recurrence and case - fatality of patients with high TS expression was 60. 00% (15/25) and 44. 00% (11/25) ,respectively. The survival analysis and Cox regression analysis showed that expression of TS were independent predictor for recurrence ( RR = 2. 65,95% CI was 0.80～8.81,P＜0.05) anddeath (RR=1.42,95%CIwas0. 36～5.58,P＜0. 05). Conclusions The probability of BUC progress and recurrence increases with the increasing of TS expression. Detection of TS expressing level can contribute to select appropriate treatment and follow-up schema.