Protease nexin-1 (PN-1) belongs to the serpin family of serine protease inhibitors. It is the phylogenetically closest relative of plasminogen activator inhibitor-1 (PAI-1). Whilst there are numerous studies of the occurrence and functions of PAI-1 in cancer, a possible tumour biological role of PN-1 has been almost totally neglected. We have now compared the level of PN-1 mRNA in 20 cases of oral squamous cell carcinomas and in matched samples of the corresponding normal oral tissues. We found that the average PN-1 mRNA level in tumours and normal tissues was significantly different, being increased up to 13 fold in tumour samples compared with the average level in normal tissues. The PN-1 mRNA level was significantly higher in tumours from patients with lymph node metastasis than in tumours from patients without. We could conclude that PN-1 is frequently overexpressed in oral squamous cell carcinomas and that its level may correlate with the occurrence of lymph node metastasis. We hypothesise that PN-1 may have a tumour biological function similar to that of PAI-1.