title: Expression of nm23-H1 predicts lymph node involvement in colorectal carcinoma.
abstract: OBJECTIVE
  Reduced expression of the metastasis suppressor gene nm23-H1 has previously been correlated with high tumor metastatic potential and fatal clinical outcome in some tumors (e.g., breast). For colorectal carcinomas, the findings are equivocal.
  
  
  METHODS
  We have used a monoclonal antibody against nm23-H1 to investigate the expression in colorectal carcinomas at the time of primary curative surgery (R0 resection) to assess if there was any relation between nm23-H1 expression and stage or histologic grade at the time of primary tumor removal.
  
  
  RESULTS
  Of 100 colorectal carcinomas studied (Stages I, II, and III according UICC, all resected curatively), nm23-H1 immunoreactivity was weak in 41 (41 percent), moderate in 24 (24 percent), and strong in 35 (35 percent) cases. The grade of positivity against nm23-H1 was significantly lower in advanced stages of the disease (Stages II or III) (P < 0.001, chi-squared = 52.8). In tumors with low or weak immunoreactivity against nm23-H1, frequency of lymph node metastases was significantly higher compared with those with moderate or strong staining (P < 0.001; chi-squared = 50.58). Therefore, with a sensitivity of 93 percent and a specificity of 58 percent, low nm23-H1 immunoreactivity of the primary tumor, assessed at the time of surgery, is an indicator of the presence of lymph node metastases.
  
  
  CONCLUSIONS
  Immunohisto-chemical evaluation of nm23-H1 in the primary tumor or in a biopsy is a useful predictor of stage of disease and presence of lymph node metastases in colorectal carcinomas and may have clinical significance, e.g., in predicting optimal therapeutic regimes.
authors.affiliation: Department of Pathology, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
authors.forename: F
authors.initials: F
authors.lastname: Köckerling
authors.forename: A
authors.initials: A
authors.lastname: Katalinic
authors.forename: C
authors.initials: C
authors.lastname: Wittekind
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D020559:Monomeric GTP-Binding Proteins; D054778:NM23 Nucleoside Diphosphate Kinases; D009363:Neoplasm Proteins / Q000032:analysis; D009367:Neoplasm Staging; D009701:Nucleoside-Diphosphate Kinase; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014157:Transcription Factors / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D054778:NM23 Nucleoside Diphosphate Kinases; D009363:Neoplasm Proteins; D014157:Transcription Factors; C517938:NME1 protein, human; D009701:Nucleoside-Diphosphate Kinase; D020559:Monomeric GTP-Binding Proteins