Expression of nm23-H1 in transitional cell carcinoma of the upper urinary tract

Transitional cell carcinoma of the upper urinary tract is an uncommon neopl asm. Relatively little information is available regarding the clinical rele vance of molecular markers. This study was performed to examine the importa nce of nm23-H1 gene expression (NM23-H1) in this type of tumors. Immunohist ochemical expression of NM23-H1 was analyzed in 90 cases of upper urinary t ract cancer, and was compared for its prognostic significance with conventi onal biological indicators. High expression of NM23-H1 was found in 7 cases (8%), intermediate expression in 32 cases (36%), and low expression in 51 cases (57%). Reduced NM23-H1 (defined as intermediate or low level of expre ssion) was associated with a higher histological grading (p=0.002), invasiv e tumor growth (p=0.002), or an increased proliferating cell nuclear antige n labeling index (p=0.004). NM23-H1 tended to inversely relate to later rec urrence or long-term survival (p=0.06), but, only tumor staging was found t o be significant in predicting clinical outcome (p=0.002). nm23-H1 appears to function as a tumor suppressor for upper urinary tract cancer, however, evaluation of NM23-H1 provides limited prognostic information.