Metallothionein (MT) is a cysteine-rich protein with pleiotropic functions and a high binding affinity for heavy metals. The present study was designed to examine the relationship between MT expression and tissue zinc levels in conjunction with cell proliferation in nasopharyngeal cancer (NPC). Proliferative activity in NPC was quantified by Ki67 immunolabelling and MT expression was determined by immunohistochemistry. Total zinc and subcellular zinc fractions were analysed by flame atomic absorption spectrometry. MT immunostaining was observed in the nuclei of NPC cells, with the percentage MT immunopositivity ranging from 3.0 to 59.7%. Thirteen tumours displayed weak MT staining and the remaining 11 showed moderate to strong immunostaining. There was a significant positive correlation between MT and Ki67 positivity (P ⍧ 0.0127). Tissue zinc levels were higher in NPC as compared with benign nasopharyngeal tissues (4.800 ⍨ 0.4610 versus 2.889 ⍨ 0.4045 µg/g dry wt tissue, respectively; P ⍧ 0.0122). Nuclear zinc levels in NPC were significantly higher than levels in membrane and cytosolic fractions (mean zinc levels 1.4840 ⍨ 0.1489, 0.6286 ⍨ 0.0789 and 0.3014 ⍨ 0.0250 µg/mg protein, respectively). A linear relationship was also observed between nuclear zinc levels and MT immunostaining (P ⍧ 0.0024) as well as with Ki67 immunopositivity (P ⍧ 0.0123). Our results show that MT and zinc are correlated with proliferative activity in NPC, providing further insights into the biology of this enigmatic and aggressive tumour.Metallothioneins (MTs) are a family of intracellular cysteinerich proteins involved in a variety of cellular processes (1-3). The pleiotropic physiological roles of MT include metalloregulatory functions in cell growth, differentiation, repair and protection against oxidative stress-induced injury and apoptosis (1,3,4). Cell proliferation is believed to be a putative function of MT as there have been reports indicating MT to be a cell cycle-dependent protein. MT-positive nuclei were observed to be present specifically in the S to G 2 M phases of the cell cycle of regenerating hepatocytes (5). A 2-to 3-fold increase in MT expression (quantitated by enzyme-linked immunosorbent Abbreviations: EGF, epidermal growth factor; MT, metallothionein; NPC, nasopharyngeal carcinoma.© Oxford University Press 1809 assay) was observed in proliferating human colonic HT-29 cells (6).The proliferative potential of MT has also been linked to zinc, a trace element which participates in the activity of a number of DNA and RNA polymerases (2,7,8). MT has a high binding affinity for zinc and Zn-MT has been hypothesized to play important roles in transmission and expression of genetic information, in response to signals for cell activation (2,8). Zinc ions are sequestered in the metal thiolate clusters of the metalloprotein (7). In this study, our aim was to investigate the relationship of MT and zinc with proliferative activity in undifferentiated nasopharyngeal carcinoma (NPC), a cancer which is common among the Chinese popul...