Expression of nm23 in gastric carcinoma - Association with tumor progression and poor prognosis

BACKGROUND. Expression of nm23 has been shown to be inversely correlated wi th the metastatic potential of several human cancers. In the current study, the expression and prognostic impact of nm23 was immunohistochemically stu died in 413 curatively resected gastric carcinomas. METHODS. Tumor sections of the 413 gastric carcinomas were stained with a p olyclonal antibody that was raised against the nm23-H1/NDP kinase A, which is identical to the nm23-H1 gene product. RESULTS, Expression of nm23 was detected in 84.5% (n = 349) of all tumors, in the majority of cases (71.2%) causing a homogeneous staining reaction in more than 75% of tumor cells. Expression of nm23 was positively correlated with the intestinal type of tumor, according to the Lauren classification and advanced pT categories, and was also correlated with the presence of bl ood and lymphatic vessel invasion. In contrast, no correlation could be dem onstrated between nm23 expression and lymph node involvement. As shown in u nivariate analysis, patients with nm23 positive tumors, especially those wi th nm23 positive diffuse-type carcinomas, had significantly shorter overall survival than patients with nm23 negative tumors (P = 0.03 and P = 0.0065, respectively). However, in a multivariate analysis that included the progn ostic parameters pT category, pN category, and blood and lymphatic Vessel i nvasion, this prognostic impact was not maintained. CONCLUSIONS. In contrast to results for breast and colorectal carcinomas, o ur results for 413 gastric carcinomas showed that expression of the designa ted metastasis suppressor gene nm23 is correlated with aggressive tumor gro wth and poor prognosis but is not an independent prognostic marker. Cancer 1998;83:2481-7. (C) 1998 American Cancer Society.