Clinical significance of intracytoplasmic nm23-H1 expression in diffuse large B-cell lymphoma.

PURPOSE: Recently, we established an ELISA technique for measuring nm23-H1 protein in serum and found that the serum nm23-H1 level is a potential prognostic factor for patients with non-Hodgkin's lymphoma. EXPERIMENTAL DESIGN: We used immunohistochemistry to examine the expression of nm23-H1 by the lymphoma cells in patients with diffuse large B-cell lymphoma (DLBCL). RESULTS: By analyzing a consecutive series of 172 untreated DLBCL patients, we found that 100 (58.1%) were strongly positive. The cytoplasmic nm23 expression in lymphoma cells correlated significantly with the serum nm23-H1 level. There was a significant correlation between patients with cytoplasmic nm23-positive lymphoma and those with performance status 2-4, stage III/IV, bulky mass, B symptoms, elevated serum level of soluble interleukin 2 receptor, and elevated serum level of C-reactive protein. Overall and progression-free survival rates were significantly lower in patients with nm23-H1-positive lymphomas than in those with nm23-H1-negative lymphomas. Similar difference was seen between patients with high and low serum levels of nm23-H1. Thus, the correlation between presence or absence of cytoplasmic nm23-H1 expression and serum nm23-H1 levels suggests that serum nm23-H1 is produced directly by lymphoma cells. CONCLUSION: We suggest that nm23-H1 expression is a prognostic factor for DLBCL, and that it is as important as serum nm23-H1, both of which are useful for planning a treatment strategy.     

Serum nm23-H1 protein as a prognostic factor for indolent non-Hodgkin's lymphoma.

Standard chemotherapy has been ineffective for improving the poor 10-year survival rate of patients with indolent lymphoma. However, a wider choice of therapeutic modalities has become recently available, including immunotherapy with monoclonal antibodies and allogeneic peripheral blood stem cell transplantation. Accordingly, a sensitive prognostic indicator is required to identify high-risk patients and to help design new therapeutic approaches for them. We previously reported that the serum nm23-H1 protein level was an independent prognostic factor for aggressive lymphoma. The present study was performed to assess the clinical implications of this protein on indolent lymphoma and whether it can be used to classify the aggressiveness of the disease in order to assist in the individualization of therapy. A total of 130 patients with indolent lymphoma were enrolled in this multicenter study. The serum nm23-H1 protein level was significantly higher in patients with indolent lymphoma than in a normal control group. In addition, indolent lymphoma patients with higher nm23-H1 levels had worse overall and progression-free survival rate than those with lower nm23-H1 levels. Therefore, nm23-H1 in serum may be useful for identifying a distinct group of patients at high risk.     

Prognostic significance of nm23-H1 expression in oral squamous cell carcinoma

Recent studies indicated nm23-H1 played a role in cancer progression. Therefore, we investigated clinical significance of nm23-H1 expression in oral squamous cell carcinoma (OSCC). In total, 86 OSCC specimens were immunohistochemically stained with nm23-H1-specific monoclonal antibodies. Immunohistochemical staining of nm23-H1 was confirmed by immunoblotting. The relations between nm23-H1 expression and clinicopathologic variables were evaluated by chi(2) analysis. As increased size of primary tumour could escalate metastatic potential and the data of patients at the late T stage might confound statistical analyses, we thus paid special attention to 54 patients at the early T stage of OSCC. Statistical difference of survival was compared by a log-rank test. Immunohistochemically, nm23-H1 expression was detected in 48.8% (42 out of 86) of tumorous specimens. It positively correlated with larger primary tumour size (P=0.03) and inversely with cigarette-smoking habit (P=0.042). In patients at the early T stage, decreased nm23 expression was associated with increased incidence of lymph node metastasis (P=0.004) and indicated poor survival (P=0.014). Tumour nm23-H1 expression is a prognostic factor for predicting better survival in OSCC patients at the early T stage, which may reflect antimetastatic potential of nm23. Therefore, modulation of nm23-H1 expression in cancer cells can provide a novel possibility of improving therapeutic strategy at this stage. In addition, our results further indicated cigarette smoking could aggravate the extent of nm23-H1 expression and possibly disease progression of OSCC patients.     

nm23-H1和MUC-1在外周T细胞淋巴瘤中的表达及其临床意义

背景与目的:外周T细胞淋巴瘤(peripheralT-celllymphoma,PTCL)是一类异质性疾病,临床侵袭性较强,常规治疗效果欠佳。国际预后指数(internationalprognosticindex,IPI)在PTCL中的价值尚未确定,有必要寻找一些分子指标来协助预测PTCL的预后。本研究旨在探讨nm23-H1和MUC-1对PTCL预后判断的价值。方法:免疫组化SP法检测中山大学肿瘤防治中心1997年1月至2004年12月间收治的96例初治PTCL患者组织中nm23-H1和MUC-1的表达情况,分析其表达与患者临床特征、近期疗效及远期生存率的关系。结果:96例患者nm23-H1和MUC-1的阳性率分别为81.2%(78/96)和58.3%(56/96);两者表达强度均与病理亚型无明显相关(P>0.05)。nm23-H1高表达与Ⅲ/Ⅳ期、PS状态≥2分、结外侵犯和结外病变数≥2等有关(P﹤0.05);而MUC-1高表达仅与分期Ⅲ/Ⅳ期、结外病变数≥2有关(P<0.05)。89例患者可评价化疗的客观疗效,全组有效率87.8%,完全缓解(CR)率56.7%。nm23-H1阴性者CR率高于阳性者(66.7%vs.55.4%,P<0.05),低表达组CR率高于高表达组(79.9%vs.44.0%,P<0.05);MUC-1阴性和低表达组的CR率分别高于阳性和高表达组,但均无显著性差异(P>0.05)。全组中位随访时间30个月(2～98个月),中位生存期32个月(95%CI26～34个月);nm23-H1阴性组5年生存率(overallsurvival,OS)明显高于阳性组(86.7%vs.24.9%,P=0.001),低表达组5年OS明显高于高表达组(52.3%vs.21.7%,P=0.000);MUC-1阴性组5年OS稍高于阳性组(47.9%vs.28.5%,P=0.260),低表达组5年OS稍高于高表达组(46.2%vs.22.2%,P=0.337)。多因素分析结果显示,IPI评分和nm23-H1表达水平是PTCL独立的预后指标。结论:nm23-H1在PTCL中过度表达提示预后不良,可作为判断PTCL预后的独立指标;MUC-1在PTCL中阳性及高表达与预后不良具一定的相关性,但对预后判断的价值尚不能确定。nm23-H1结合IPI评分等临床指标可能有助于更精确判断PTCL的预后。     

Expression of nm23-H1 and nm23-H2 protein in endometrial carcinoma.

nm23 gene expression has been shown to be inversely correlated with tumour metastatic potential in some cancers but not in others. Examination was made of the expression of nm23-H1 and nm23-H2 gene products by immunohistochemistry and immunoblotting in 28 endometrial carcinomas. Immunohistochemistry indicated the cytoplasm of cancer cells to be positive, and myometrium and endometrial stromal cells negative, for nm23-H1 and -H2 protein. The staining intensity for these proteins was significantly stronger in well-differentiated adenocarcinomas (G1) than in those moderately differentiated (G2) (P < 0.05). nm23-H1 and -H2 proteins were shown by immunoblotting to be present at significantly higher levels in G1 than in G2 tumours (P < 0.05). Two of eight cases expressed high nm23-H1 and -H2 protein in poorly differentiated adenocarcinomas (G3). In G3 tumours, nm23 expression may be diverse. In this study, the expression of nm23-H1 and -H2 was not correlated with stage, metastasis, tumour size, myometrial invasion, oestrogen receptor, progesterone receptor or menopause. It follows from the findings presented above that the high expression of nm23-H1 and -H2 is positively correlated with histological differentiation.     

膀胱癌中MMP-2与nm23的表达及其临床意义

目的　探讨膀胱癌组织中的MMP - 2与nm2 3-H1蛋白的表达及其临床意义。方法　采用免疫组化S -P法分析 6 3例手术切除膀胱癌中MMP - 2与nm2 3-H1蛋白的表达情况。结果　MMP - 2在膀胱移行细胞癌与乳头状瘤中的表达有显著性差异 (P <0 0 5 ) ,其表达与肿瘤分级与临床分期呈正相关 ;nm2 3-H1蛋白表达与肿瘤分期呈负相关 ,在肿瘤组织中随TCCB临床病理分期升高 ,MMP - 2表达增高趋势有显著性差异 ,而nm2 3-H1的表达随TCCB分级及临床分期的升高而呈现降低趋势 ,且有显著性差异 (P <0 0 5 )。结论　检测膀胱癌转移相关基因表达并分析其表达的相互关系 ,有助于判断膀胱癌的转移潜能及指导术后干预治疗     

nm23-H1与Tiam1在睑板腺癌中的表达及意义

目的:检测睑板腺癌组织中nm23-H1及Tiam1的表达,探讨其与临床病理特征的关系,评价其临床意义.方法:睑板腺癌标本34例及癌旁正常组织34例,应用Western blot法及qRT-PCR检测nm23-H1和Tiam1蛋白及mRNA的表达,观察其蛋白水平表达与临床病理特征的相关性,观察其与睑板腺癌术后复发的关系.结果:nm23-H1蛋白及mRNA在睑板腺癌组织中表达高于癌旁组织(P<0.05),Tiam1蛋白及mRNA在睑板腺癌组织中表达高于癌旁组织,差异有统计学意义(P<0.05).nm23-H1 及Tiam1蛋白表达水平与肿瘤直径、TNM分期、淋巴结转移及肿瘤分化程度有相关性(P<0.05),nm23-H1 及Tiam1与睑板腺癌术后复发率具有相关性,在复发的睑板腺癌中nm23-H1及 Tiam1表达高于未复发者(P<0.05).结论:nm23-H1和Tiam1表达水平与睑板腺癌的临床病理特征具有相关性,nm23-H1和Tiam1高表达提示睑板腺癌患者不良预后.     

垂体腺瘤nm23-H_1基因表达的临床意义

目的明确nm23-H_1基因在垂体腺瘤中的表达及其临床意义。方法采用免疫组织化学染色（SP）法对62例垂体腺瘤nm23-H_1基因表达进行回顾性研究。结果侵袭型垂体腺瘤nm-H_1基因表达水平显著低于非侵袭型（P＜0.01）;Ⅲ、Ⅳ级垂体腺癌nm23-H_1基因表达水平显著低于Ⅰ、Ⅱ级（P＜0.05）;nm23-H_1基因表达水平下降与垂体腺瘤患者的性别、年龄及肿瘤分泌功能无显著相关性（P＞0.05）。结论nm23-H_1基因可能在会作腺瘤的侵袭过程中起重要作用,其表达改变是反映垂体腺癌侵袭性的敏感指标。     

PTEN及nm23-H1蛋白表达在非小细胞肺癌转移中的意义

背景与目的PTEN及nm23-H1基因均被证实是肿瘤转移的抑制基因,目前大多数研究都停留在基础研究上,本研究通过检测PTEN及nm23-H1蛋白在非小细胞肺癌(NSCLC)中的表达,以探讨它们的临床意义及相互关系。方法应用免疫组织化学法检测60例非小细胞肺癌组织中PTEN及nm23-H1基因蛋白的表达。结果NSCLC无淋巴结转移组PTEN蛋白阳性表达率为79.31%,高于NSCLC伴有淋巴结转移组41.94%,两者差异有统计学意义(P<0.01);无淋巴结转移组nm23-H1蛋白阳性表达率为82.76%,高于NSCLC伴有淋巴结转移组45.16%,两者差异有统计学意义(P<0.01)。PTEN和nm23-H1蛋白表达在NSCLC中一致性较好(Kappa=0.4366,Z=3.3905,P<0.01),两基因可能有协同作用。结论PTEN及nm23-H1蛋白表达均与NSCLC的淋巴结转移有关,PTEN和nm23-H1蛋白均可作为预测肿瘤转移的重要指标,对两种蛋白进行免疫组织化学联合检测,可能更有利于肺癌预测淋巴结转移及预后。     

A clinicopathological study of nm23-H1 expression in classical Hodgkin’s lymphoma

BackgroundWe carried out immunohistochemistry to examine the expression of nm23-H1 in Hodgkin and Reed–Sternberg cells in patients with classical Hodgkin’s lymphoma (CHL).Patients and methodsWe evaluated 128 patients with CHL [87 patients with nodular sclerosis (NS) and 41 patients with mixed cellularity (MC)] for CD15, CD20, Ki-67, EBER, TIA-1, and nm23-H1 by immunohistochemistry.ResultsCD15 was expressed in 79%, CD20 in 11%, Ki-67 in 93%, EBER in 34%, TIA-1 in 11%, and nm23-H1 in 60% of the CHL patients. NS patients showed a significantly higher rate of nm23-H1 expression than MC patients (P < 0.001). The serum nm23-H1 level was significantly higher in patients with positive nm23 expression. Univariate analysis showed that stage IV, poor performance status, low hemoglobin level, low serum albumin level, age of 45 years or older, TIA-1-positive status, and nm23-H1-positive status were associated with significantly shorter progression-free survival. Multivariate analysis with these factors showed TIA-1 and cytoplasmic nm23-H1 expression to be significant and independent prognostic factors.ConclusionsOur results indicate that nm23-H1 expression is a prognostic factor for CHL and that it is as important as serum nm23-H1, both of which are useful for planning the treatment strategy.     

肿瘤转移相关基因在甲状腺乳头状癌的表达与颈淋巴结转移相关性研究

目的：探讨肿瘤转移抑制相关基因nm23-H1,转移相关基因CD44v6在甲状腺乳头状癌的表达与颈淋巴结转移的关系。方法：采用免疫组化S－P法,检测201例甲状腺乳头状癌、30例甲状腺良性病变及30例正常甲状腺组织中nm23-H1和CD44v6的表达情况。结果：1）nm23-H1在甲状腺乳头状癌组的表达阳性率62．7％,明显低于良性病变组和正常组（P＜）．01或P＜0．05）。有转移组nm23-H1的阳性率为54．5％,明显低于无转移组（75．0％）,其蛋白表达与颈淋巴结转移呈负相关。2）CD44 v6在甲状腺乳头状癌组的表达阳性率为71．1％,明显高于两对照组（P均＜0．01）。有转移组CD44v6的阳性率为79．3％,明显高于无转移组（58．5％）,其蛋白表达与颈淋巴结转移呈正相关。3）甲状腺乳头状癌中nm23-H1和CD44v6表达呈显著负相关关系（P＜0．01）。nm23-H1阴性表达伴CD44v6阳性表达的患者发生颈淋巴结转移的可能性大。结论：nm23-H1和CD44v6的表达与甲状腺乳头状癌的颈淋巴结转移密切相关,nm23-H1和CD44v6的表达在淋巴结转移中起协同作用,两者的表达失衡可能与甲状腺乳头状癌发生颈淋巴结转移有密切关系。因此,检测nm23-H1和CD44v6可能作为预测甲状腺乳头状癌颈淋巴结转移潜能的有价值的参考指标。     

Clinical significance of serum NM23-H1 protein in neuroblastoma

We have previously reported that NM23 genes are overexpressed in various hematological malignancies and that serum NM23-H1 protein levels are useful for predicting patient outcomes. In this study we assessed the clinical implications of serum NM23-H1 protein on neuroblastoma. We examined serum NM23-H1 protein levels in 217 patients with neuroblastoma, including 131 found by mass-screening and 86 found clinically by an enzyme-linked immunosorbent assay, and determined the association between levels of this protein, and known prognostic factors or the clinical outcome. The serum NM23-H1 protein level was higher in neuroblastoma patients than in control children (P < 0.0001). Patients with MYCN amplification had higher serum NM23-H1 levels than those with a single copy of MYCN. Overall survival was assessed in the 86 patients found clinically, and was found to be worse in patients with higher serum MN23-H1 levels (> or = 250 ng/mL) than in those with lower levels (< 250 ng/mL; P = 0.034). The higher level of NM23-H1 was correlated with a worse outcome in patients with a single MYCN copy, or in those younger than 12 months of age. Serum NM23-H1 protein levels may contribute to predictions of clinical outcome in patients with neuroblastoma.     

Expression of nm23-H1 in uveal melanoma

Uveal melanoma (UM) is the most common malignant intraocular tumor in adults. Despite the high accuracy of clinical diagnosis and advances in local treatment, more than 50% of UM patients develop metastasis within 10 years of initial diagnosis. NM23 is one of the human metastasis suppressor genes. Reduced nm23-H1 expression is correlated with high metastatic potential in many different cancers. The purpose of this study is to investigate the expression of nm23-H1 in UM and its potential value as a prognostic marker. Immunostaining of nm23-H1 was verified in five human UM cell lines with different metastatic potentials. The expression level of nm23-H1 mRNA was evaluated with one-step quantitative real-time PCR. The invasion ability of the cell lines was assessed before and after silencing nm23-H1 with small interference RNA. Thirty-two cases of paraffin-embedded specimens of human UM were immunostained with nm23-H1 monoclonal antibody. The immunostaining was evaluated in a semiquantitative fashion based on extent and intensity. The real-time PCR results of five human UM cell lines showed that expression of nm23-H1 was higher in cell lines with low metastatic potential compared with those with high metastatic potential (P<0.05). The invasive ability of the UM cell lines increased after silencing nm23-H1 expression with small interference RNA (P<0.05). The immunostaining of nm23-H1 was cytoplasmic in all cell lines and UM patients samples. The increased immunostaining intensity of nm23-H1 in patients' samples was associated with better survival rate (Kaplan-Meier test P=0.0097). The expression of nm23-H1 was not correlated with other prognostic factors. It can be concluded that nm23-H1 may be a prognostic marker to predict the survival rate of UM patients and it has the potential to identify high-risk patients.     

nm23-H1基因在喉癌中杂合性丢失和微卫星序列不稳定性分析及表达的研究

目的　探讨nm2 3 H1基因在喉鳞状细胞癌中杂合性丢失 (LOH)及表达情况。方法　选择nm2 3 H1基因内部及附近 5个微卫星多态标记 ,对 72例喉癌标本进行杂合性丢失和微卫星序列不稳定性检测 ,同时以RT PCR方法分析 38例配对喉鳞状细胞癌标本中nm2 3 H1基因表达情况。结果　LOH涉及至少 1个位点的频率高达 76 .39% ,5个位点均有LOH ,以D17S16 6 5处频率最高 ,达 38.10 %。 3个位点出现MI ,最高为 12 .70 %。nm2 3 H1基因杂合性丢失及微卫星不稳定与淋巴结转移、临床分期和肿瘤分化无显著相关性 (P >0 .0 5 ) ,但D17S16 6 5位点高LOH频率与低分化相关 (P <0 .0 5 )。癌、癌旁及转移淋巴结中nm2 3 H1表达不同 ,但差异无统计学意义 ,表达水平与淋巴结转移无关 (P >0 .0 5 )。结论　nm2 3 H1基因可能在喉鳞癌发生中起作用 ,杂合性丢失可能是影响基因功能的主要机制。     

nm23-H1转染对肺癌L9981细胞株整合素家族的影响

目的:探讨nm23-H1基因对肺癌细胞整合素分子表达的影响。方法:利用半定量RT-PCR技术检测转染前后integrinβ1、integrinβ3基因的mRNA表达;流式细胞仪检测转染前后integrinβ1、integrinβ3基因的蛋白表达。结果:转染后细胞株integrinβ1、integrinβ3 mRNA与蛋白表达下调。结论:nm23-H1基因对肺癌细胞株L9981 integrinβ1、integrinβ3 mRNA与蛋白表达具有负调控作用。     

p53、C-erbB-2和nm23基因表达在非小细胞肺癌中的临床意义

目的：探讨p53．C-erbB-2和nm23基因在非小细胞肺癌（NSCLC）组织中表达的临床意义。方法：组织学或细胞学证实的NSCLC89例,采用免疫组化法检测p53、C-erbB-2和nm23蛋白表达,并取癌旁正常肺组织87例作为对照。结果：肺癌组织p53和C-erbB-2蛋白表达率分别为60％和67％,均高于正常肺组织5％和3％（P〈0．05）;nm23蛋白表达为67％,则显著低于正常肺组织93％（P〈0．05）：p53蛋白表达与肺癌组织的病理类型、原发肿瘤范围（T）和肿瘤分化程度有显著的相关性（P〈0．05）,与患者的性别、年龄、疾病分期（TNM）、淋巴结受侵范围（N）和远处转移状况（M）没有明显的相关性。C-erbB-2蛋白表达与患者的性别、年龄、原发肿瘤大小（T）、淋巴结受侵范围（N）和远处转移状况（M）、疾病分期（TNM）及肿瘤分化程度均没有明显的相关性。nm23蛋白表达与肿瘤的淋巴结受侵范围（N）、远处转移状况（M）和疾病分期（TNM）存在显著相关性（P〈0．05）,与患者的性别、年龄、原发肿瘤大小（T）及分化程度没有显著相关性。结论：p53基因编码的蛋白在NSCLC表达增高及nm23基冈编码的蛋白表达降低,提示p53和nm23基因在NSCLC的发生发展、病理特征和转移中可能起重要作用。     

The role of nm23-H1 in the progression of transitional cell bladder cancer.

The nm23 gene was initially cloned as a metastasis suppressor gene, but the clinical relevance of nm23-H1 as a metastasis suppressor or prognostic indicator for human cancers remains enigmatic. Given that gene expression is regulated at the tissue-specific level, we studied the molecular mechanisms of nm23-H1 expression in human bladder cancer cell lines and the clinical importance of protein product (NM23-H1) in association with patient outcome (n = 257) by immunohistochemistry. We demonstrated that nm23-H1 is expressed in bladder cancer cells without genomic alterations. High NM23-H1 expression was found in 39 cases (15.2%), intermediate expression in 119 cases (46.3%), and low NM23-H1 in 99 cases (38.5%). NM23-H1 was inversely related to staging classification or tumor size (P < 0.05), with the most significant difference being observed between pTa tumors and those of pT1-pT3 bladder cancer (P = 0.01). Reduced NM23-H1, defined as intermediate and low levels of expression, tended to have a higher risk of tumor metastasis (P = 0.06) or poor longtime survival (P = 0.07). In the subset of grade 2 bladder tumors, reduced NM23-H1 significantly correlated with the occurrence of tumor metastasis or poor patient survival (P < 0.05). These findings overall suggest that nm23-H1 may play an important role in suppressing the early step of carcinogenesis and thus act as an invasion suppressor for human bladder cancer. A prospective study is required to clarify the potential of the molecular marker in prediction of disease progression.     

Expression of nm23-H1 gene product in nasopharyngeal carcinoma and its clinical significance

Objective: The nm23 gene is one of the tumor metastatic suppressor genes. The expression of nm23-H1 has been reported to be inversely associated with metastatic potentiality in a number of human carcinomas, including breast, colorectal, gastric, hepatocellular and gallbladder carcinomas. In this study, the immunohisto-chemical staining of nm23-H1 protein in human naso-pharyngeal carcinoma (NPC) was examined, and the relationship between nm23-H1 and both metastasis and prognosis of patients with NPC was also investigated. Methods: Routine LSAB immunohistochemistry with the nm23-H1 monoclonal murine antibody was employed to study the expression of nm23-H1 protein in 95 paraffin-embedded specimens of NPC treated at our hospital. The clinical pathologic data and results of follow-up were also retrieved. Comparisons between patients with and without expression of nm23-H1 protein with respect to metastasis, loco-regional recurrence and survival were performed using Log rank test. Multivariate prognostic analyses were performed by using Cox’s regression model. Results: Nm23-H1 negative expressive tumors were associated with a higher incidence of lymph-node metastasis (86.7%) than those of nm23-H1 positive (48.6%,P<0.01). Nm23-Hl negative expressive tumors were associated with a high incidence of recurrence and distant metastasis after radiotherapy (P<0.05). A significant association was found between expression of nm23-H1 and prognosis (P<0.01). The expression of nm23-H1 indicated favorable prognosis. Conclusion: It was suggested that nm23-H1 negative expression was significantly associated with lymph-node metastasis, recurrence and distant metastasis. Nm23-H1 may have value for predicting the prognosis of NPC.