High expression of human nonmetastatic clone 23 type 1 in cancer of uterine cervix and its association with poor cell differentiation and worse overall survival

Background and Objectives: The role of human nonmetastatic clone 23 type 1 (nm23-H1), a metastasis-associated gene, is less clear-cut in cancer of uterine cervix; therefore, we investigate its expression in cancer tissues and its correlation with clinicopathologic variables and survival of patients. Methods: Thirty cervical cancer tissues and their normal counterparts were collected to evaluate quantitative nm23-H1 mRNA expression. From them, 16 cancer and 16 normal tissues were collected and added with another 64 cancer tissues to construct a 96-tissue core microarray for immunohistochemical study. We evaluated the relationships among nm23-H1 immunostaining using semi-quantitative H scores, clinicopathologic parameters, recurrence and survival in cervical cancer patients. Results: Nm23-H1 mRNA expression and H score (median H scores: 2.0 vs. 0.3, P = 0.001) were higher in cervical cancer tissues than normal counterparts, respectively. Nm23-H1 expression was significantly associated with depth of stromal invasion (P = 0.003), tumor diameter (P = 0.044) and cell differentiation (P = 0.025). Other than stage II, poor cell differentiation as well as positive parametrium invasion and lymph node metastasis, positive nm23-H1 expression was significantly correlated with poor overall survival. Conclusion: High nm23-H1 expression is predictive of worse overall survival for cervical cancer patients.