The nm23 gene has been implicated as a suppressor gene involved in the control of the metastatic process of malignant cells. Reduced levels of nm23 gene product have been found in tumor cells with high metastatic potential such as several types of rodent tumors and human breast, colorectal, and lung carcinoma. This pilot study examines the expression of the nm23 gene product compared with nodal status in 70 consecutive patients with squamous cell carcinomas of the head and neck. Immunohistochemical staining was carried out on these tumor tissues with a monoclonal antibody to nm23-H1 peptide sequence. The tissues were scored from 0 to 2 by 2 independent observers. Reduced immunoreactivity, grades 0 and 1, was observed in 30 patients with positive nodal status (N = 34, 88%). Strong immunoreactivity, grade 2, was observed in 20 patients with negative nodal status (N = 36, 56%). Reduced expression of nm23 gene product was observed in patients with positive lymph node metastasis (P = 0.0006, χ2). However, no significant differences in survival of these groups based on nm23 expression could be shown with the Kaplan-Meier analysis. This initial finding in the difference of nm23 gene product expression in patients with differing lymph node status is exciting but must be further validated with future studies.
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