NM23 IN OVARIAN-CANCER - CORRELATION WITH CLINICAL OUTCOME AND OTHER CLINICOPATHOLOGICAL AND BIOCHEMICAL PROGNOSTIC PARAMETERS

Purpose: The aim of the study was to define the prognostic role of the metastasis suppressor gene, nm23, in 106 primary ovarian cancer patie nts. Patients and Methods: Northern and Western blotting analysis of n m23-H1 and nm23-H2 expression were performed in a subset of ovarian tu mors. Immunohistochemical analysis was performed on formalin-fixed par affin-embedded specimens from 106 primary ovarian carcinomas by the an tihuman nm23 monoclonal antibody. Results: Northern and Western blotti ng analysis demonstrated a direct association between nm23-H1 and nm23 -H2 levels. Moreover, an overall concordance of 86.7% between Northern blotting and immunohistochemical data was observed. Sixty-six specime ns (68%) showed a positive nm23-H1 immunoreaction. The percentage of n m23-H1 positivity was higher in lymph nodenegative (70%) than in lymph node-positive cases (44%) (P=.049). Moreover, the percentage of compl ete/partial responses to chemotherapy wets higher in nm23-H1-positive (69%) than in nm23-H1-negative (44%) patients (P=.03). The percentage of epidermal growth factor receptor (EGFR) positive cases was lower in nm23-H1-positive (44%) than in nm23-H1-negative immunostained (72%) s amples (P=.012). Lower ras/p21 levels (median, 1.77 absorbance units) were found in nm23-H1-positive than in nm23-H1-negative samples (media n, 2.63 absorbance units) (P=.03), The 6-year progression-free surviva l (PFS) rate of nm23-H1-positive cases was 50% (95% confidence interva l [CI], 33 to 67) versus 12% (95% CI, -2 to 26) for nm23-H1-negative p atients (P=.0056). In multivariate analysis, only stage, ascites, and nm23-H1 content retained independent prognostic roles. Conclusion: The assessment of nm23 content may provide useful information for prognos tic characterization of ovarian cancer patients. (C) 1996 by American Society of Clinical Oncology.