Changes in thymidine phosphorylase gene expression related to treatment of rectal cancer.

BACKGROUND: The enzyme thymidine phosphorylase (TYMP) has tumor-promoting functions and its expression is often elevated in tumors. PATIENTS AND METHODS: TYMP gene expression in tumorous and mucosal tissues was assessed using real-time polymerase chain reaction, in a study of patients with rectal cancer where chemotherapy and radiotherapy were given sequentially. RESULTS: TYMP levels decreased after chemotherapy. For patients given radiotherapy, there was a significant increase in TYMP expression comparing biopsies before and after radiotherapy. The increase was also observed in the mucosa, although it was less pronounced. CONCLUSION: Cancer treatment alters gene expression in tumor and adjacent mucosa of patients with rectal cancer. Chemotherapy may cause a decrease in TYMP gene expression, whereas radiotherapy, given as adjuvant treatment, causes a significant increase in expression. These results are of importance when interpreting TYMP expression data in rectal cancer and may be of clinical interest as TYMP participates in the activation of capecitabine.

Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden.

Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol ≥ 50 nmol/l at DST in combination with basal ACTH <2 pmol/l. In patients with unilateral AI 42% (76/180) had inadequate suppression at DST and 23% (27/115) had SH. The probability for SH and inadequate suppression at DST correlated positively to size and inversely to attenuation at CT. Bilateral AI were found in 43 patients and of these 70% (30/43) had inadequate suppression at DST and 42% (13/31) SH. The patients with SH or inadequate suppression at DST had increased frequency of hypertension which increased further in patients with post-DST cortisol ≥ 140 nmol/l. The applied criterion for SH is useful for initial evaluation of patients with AI. SH is common in patients with AI, particular in bilateral disease. In patients with unilateral AI the probability for SH correlated positively to size and inversely to attenuation at CT. Furthermore, SH and the post-DST cortisol concentration was associated with hypertension.