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In the present study, an analysis of whether expression of nm23-H1 and nm23-H2 proteins has prognostic significance was performed. A series of 95 renal cell carcinomas was analyzed for nuclear grade, tumor size (larger than 50 mm or not), staging in the Robson system and expression of nm23-H1 and nm23-H2, as well as patient survival. Immunohistochemical staining of nm23-H1 and nm23-H2 was found in 68.4 and 50.5% of the cases, respectively. Significant differences in nm23-H1, but not nm23-H2 expression were noted with regard to nuclear grade and tumor size. The patients with nm23-H1-expression-negative tumors sized ≤50 mm had a significantly poorer prognosis than their positive counterparts. Multivariate analysis using the Cox proportional hazards regression model indicated that the staging in the Robson system and expression of nm23-H1 were significant and independent prognostic factors for survival. However, no significant correlation between the incidence of metastasis and expression of nm23-H1 or nm23-H2 was found. The results imply that reduced expression of nm23-H1 influences the prognosis of patients with renal cell carcinomas, but not the likelihood of metastasis. In small tumors sized ≤50 mm, reduced expression of nm23-H1 protein was suggested to be an especially strong predictor of a poor prognosis. [ABSTRACT FROM AUTHOR]