Prognostic value of nm23 expression in stage IB1 cervical carcinoma

Background: The purpose of this retrospective study was to evaluate the pat terns of nm23 expression in stage IB1 squamous cell carcinoma of the uterin e cervix, to compare nm23 expression with clinicopathological findings and to assess its prognostic value. Methods: Twenty-seven patients with stage IB1 squamous cell carcinoma of th e uterine cervix underwent abdominal radical hysterectomy and pelvic lymph node dissection. Expression of nm23 was studied immunohistochemically, foll owed by amplification and direct sequencing of exons 4 and 5 of the nm23 ge ne. Results: Overexpression of nm23 was detected in 18.5% of the tumors and low expression was seen in 33.3%, while negative expression was found in 48.1% of the tumors. Deep cervical stromal invasion (greater than or equal to1/2 ) was found to be associated with the increased risk of lymph node metastas es (odds ratio = 17.5). A significantly lower percentage of patients surviv ed when nm23 overexpression was observed (p = 0.0063). Univariate analysis revealed that tumor size (2-3.9 cm), lymph node metastasis, tumor invasion into parametria, tumor invasion into blood/lymph vessel, squamous cell carc inoma (greater than or equal to2 ng/ml) and nm23 overexpression had a signi ficantly lower recurrence-free survival rate of the patients. None of the a bove factors was significant according to multivariate analysis. There were no mutations in exons 4 and 5 of the nm23 gene in stage IB1 squamous cell carcinoma of the uterine cervix. Conclusions: This study suggests that expression of nm23 may be indicative of an unfavorable prognosis in patients with stage IB1 squamous cell carcin oma of the uterine cervix.