Nm23-H1 nuclear expression is associated with a more favourable prognosis in laryngeal carcinoma: univariate and multivariate analysis

Aims: To use image analysis and multivariate analysis to investigate the prognostic significance of Nm23-H1 subcellular localization in a large cohort of laryngeal squamous cell carcinomas (LSCCs). Methods and results: Nm23-H1 total and nuclear levels were immunohistochemically determined and calculated with an image analysis system in 104 consecutively operated LSCCs. The mean follow-up was 58.3 +/- 35.1 months (median 45 months). Total Nm23-H1 levels correlated only with patient stratification by pT (P = 0.01). Mean nuclear Nm23-H1 levels were lower in patients with recurrent disease (P = 0.01), and disease-free survival (DFS) was longer in patients whose nuclear levels of Nm23-H1 were >2.0% than in those with levels <= 2.0% (P = 0.019). On multivariate analysis, Nm23-H1 nuclear expression [hazard ratio (HR) 2.59, P = 0.005] and N stage (HR 3.60, P = 0.0001) were prognostically significant in relation to DFS. Conclusions: In LSCC, Nm23-H1 nuclear expression may be useful for identifying patients at higher risk of recurrence after treatment and who might be considered for more aggressive therapy. Further investigations are needed before Nm23-H1 can be considered for use in targeted treatments for LSCC.