Clinical value of thymidine kinase in patients with cervical carcinoma

Objective: Our purpose was to determine the clinical value of thymidine kin ase (TK), which is an important pyrimidine pathway enzyme involved in salva ge DNA synthesis, in patients with cervical carcinoma. Methods: We examined TK mRNA expression by reverse transcription polymerase chain reaction in 1 9 tissue specimens of invasive cervical carcinoma and 9 normal cervices and related it to thymidylate synthase (TS) and thymidine phosphorylase (TP) m RNA expressions. Serum TK level was determined by radioenzymatic assay in 7 9 patients with invasive cervical carcinoma, 7 patients with microinvasive carcinoma, 21 patients with carcinoma in situ and 32 normal women. Results: TK mRNA expression was upregulated in invasive cervical carcinoma compared with the normal cervix (p < 0.05) and significantly correlated with TS mRN A expression (p < 0.0001) but not with TP mRNA expression. The serum TK lev el was significantly higher in patients with invasive carcinoma than in nor mal women and patients with carcinoma in situ (p < 0.01 and p < 0.05). In p atients with invasive cervical carcinoma, the serum TK level significantly correlated with TK mRNA expression (p < 0.05), but not with any conventiona l clinicopathologic factors. High serum TK levels significantly correlated with a poorer survival (p < 0.05), and multivariate analysis showed serum T K level to be an independent prognostic factor (p < 0.05). Conclusion:TK ma y play an important role in influencing the malignant behavior of cervical carcinoma, and measurement of the serum TK level may be useful in predictin g survival in patients with cervical carcinoma. Copyright (C) 2001 S. Karge r AG, Basel.