Expression of inducible nitric oxide synthase in breast cancer correlates with metastatic disease

Breast cancer is characterized by its ability to metastasize rapidly. Factors that might facilitate this metastatic potential include tumor vascularity. Nitric oxide (NO), a labile compound synthesized by NO synthase (NOS), is a major regulator not only of physiologic vascular tone but also of the abnormal vascularity associated with many tumors. To test whether NOS is expressed in primary breast tumors and whether its expression is associated with the presence of metastasis, we analyzed the expression of the inducible NOS in 22 primary breast tumors, and to investigate its association to other gene products related to the metastatic ability of tumor cells, we correlated the expression of the inducible NOS with the expression of the nm23 protein (the product of the putative antimetastatic gene nm23). We found a very strong correlation between the presence of NOS and axillary lymph node metastasis and between NOS and the absence of nm23 protein. These data suggest that NO synthesis and the resulting increase in blood flow to the tumor play a role in the facilitation of tumor metastasis.