Molecular tumor markers hold considerable promise for accurately predicting the recurrence and progression of colorectal cancer (CRC) in patients. However, in the majority of cases, single marker analysis has been found to have low accuracy, and is of little practical use in clinical practice. The present study investigated the prognostic value of the combined detection of the protein expression of metastasis suppressor 23-H1 (Nm23-H1) and p53 using immunohistochemical analysis, and the mRNA expression levels were analyzed using reverse transcription-quantitative polymerase chain reaction in 110 cases of stage II and III CRC. The results revealed that the expression levels of Nm23-H1 in CRC tissues were lower, compared with those in normal tissues (χ²=18.249; P<0.001), and the protein expression levels of p53 were higher in the CRC tissues (χ²=23.940; P<0.001); although the mRNA expression levels of Nm23-H1 and p53 presented with the same trend. The protein expression of Nm23-H1 was correlated with lymph node metastases (χ²=11.847; P=0.001) and pathological patterns (χ²=6.911; P=0.032). However, it did not correlate with patient gender or age, or with tumor World Health Organization classification or invasive depth (P>0.05). No significant correlation was observed between the expression of p53 and clinicopathological features (P>0.05). Patients with CRC with Nm23-H1(+)/p53(-) tumors had increased survival rates, with a five-year overall survival rate of 83.8% and a five-year disease-free survival rate of 70.2%. The five-year overall survival rates in other study cohorts were lower, compared with the Nm23-H1(+)/p53(-) group (P<0.0125), and this was the same for the five-year disease-free survival rate (P<0.0125). In conclusion, the present study demonstrated that the combined detection of the protein expression of Nm23-H1 and p53 was associated with the long term survival rates of patients with stage II and III CRC; and this may offer potential for use as a predictor of survival rates in patients with CRC.

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