IMMUNOHISTOCHEMICAL EVALUATION OF NM23-H-1 GENE-PRODUCT IN TRANSITIONAL-CELL CARCINOMA OF THE BLADDER

The expression of the nm23-H-1 gene has been suggested to have an inve rse association with metastases in certain tumours. The aim of this st udy was to investigate the relationship of nm23-H-1 immunohistochemica l expression with pathological tumour variables and survival in a seri es of transitional cell carcinomas (TCCs) of the bladder. Formalin-fix ed, paraffin-embedded archival tissue from 87 carcinomas (T-a-T-1 45 c ases) and T-2-T-4 (42 cases) was immunostained (Strept ABC/HRP) with t he NDPK-A monoclonal antibody (NDPK-A) against nm23-H-1 protein. The t umours had already been evaluated for immune-expression of p53 protein . In addition, DNA analysis was performed by flow cytometry. Results w ere analysed using the linear trend in proportions test, the Fisher's exact test and multivariate analysis. Paradoxically, advanced tumour s tage showed significant correlation with nm23-H-1 immunopositivity in muscle invasive TCCs (P-t = 0.01). Patients with nm23-H-1 positive, mu scle invasive TCC had a worse prognosis at a level of suggestive stati stical significance (P-F = 0.08). In multivariate analysis, using a Co x's proportional hazards survival model with six variables, tumour gra de, disease stage and synchronous p53 and nm23-H-1 detection showed si gnificant correlation with poor patient survival (P = 0.014, P = 0.049 and P = 0.05, respectively).