RESUMO
The ability of parabens to promote the appearance of multiple cancer hallmarks in breast epithelium cells provides grounds for regulatory review of the implication of the presence of parabens in human breast tissue. It is well documented that telomere dysfunction plays a significant role in the initiation of genomic instability during carcinogenesis in human breast cancer. In the present study, we evaluated the genotoxic effect of ethyl 4-hydroxybenzoate (ethyl-paraben), with and without metabolic activation (S9), in studies following OECD guidelines. We observed a significant increase in genotoxic damage using the Mouse Lymphoma Assay and in vitro micronucleus (MN) tests in the L5178Y cell line in the presence of S9 only after a short exposure. A high frequency of MN was observed in the TK6 cells after a short exposure (3 h) in the presence of S9 and a long exposure (26 h) without S9. We found significant increases in the MN frequency and induced chromosomal aberrations in the lymphocytes of only one donor after ethyl-paraben exposure in the presence of S9 after a short exposure. Cytogenetic characterization of the paraben-treated cells demonstrated telomere shortening associated with telomere loss and telomere deletions in L5178Y and TK6 cells and lymphocytes of the paraben sensitive-donor. In a control cohort of 68 human lymphocytes, telomere length and telomere aberrations were age-dependent and showed high inter-individual variation. This study is the first to link telomere shortening and the genotoxic effect of ethyl paraben in the presence of S9 and raises the possibility that telomere shortening may be a proxy for underlying inter-individual sensitivity to ethyl-paraben. Copyright © 2016 John Wiley & Sons, Ltd.
Assuntos
Micronúcleos com Defeito Cromossômico/induzido quimicamente , Mutagênicos/toxicidade , Parabenos/toxicidade , Encurtamento do Telômero/efeitos dos fármacos , Ativação Metabólica , Animais , Técnicas de Cultura de Células , Linhagem Celular Tumoral , Humanos , Linfócitos/efeitos dos fármacos , Linfócitos/patologia , Camundongos , Micronúcleos com Defeito Cromossômico/estatística & dados numéricos , Microssomos Hepáticos/metabolismo , Ratos Sprague-DawleyRESUMO
BACKGROUND: A relation between telomere attrition in early carcinogenesis and activation of DNA damage response (DDR) has been proposed. We explored telomere length and its link with DDR in colorectal multistep carcinogenesis. PATIENTS AND METHODS: We studied normal mucosa, low-grade dysplasia (LGD) and high-grade dysplasia (HGD) and invasive carcinoma (IC) in matched human colon specimens by evaluating p-ataxia telangiectasia mutated (ATM), p-checkpoint kinase 2 (Chk2), c-H2AX, TRF1 and TRF2 expressions by immunohistochemistry. FISH was used to assess telomere length. RESULTS: Telomeres shortened significantly from normal (N) to LGD and HGD (P < 0.0001; P = 0.012), then increased in length in IC (P = 0.006). TRF1 and TRF2 expressions were diminished from N to LGD and HGD (P = 0.004, P < 0.0001, ns) and were reexpressed at the invasive stage (P = 0.053 and P = 0.046). Phosphorylated ATM, Chk2 and H2AX appeared already in LGD (respectively, P = 0.001, P = 0.002 and P = 0.02). Their expression decreased from HGD to IC (respectively, P = 0.03, P = 0.02 and P = 0.37). These activating phosphorylations were inversely correlated with telomere length and TRF1/2 expression. CONCLUSION: In a model of colon multistep carcinogenesis, our data indicate that telomeric length and protein expression levels are inversely correlated with the activation of the DDR pathway.
Assuntos
Neoplasias Colorretais/genética , Dano ao DNA , Lesões Pré-Cancerosas/genética , Telômero/metabolismo , Telômero/patologia , Anticorpos Antineoplásicos/análise , Proteínas Mutadas de Ataxia Telangiectasia , Proteínas de Ciclo Celular/biossíntese , Quinase do Ponto de Checagem 2 , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Proteínas de Ligação a DNA/biossíntese , Regulação para Baixo , Células HT29 , Histonas/biossíntese , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Inclusão em Parafina , Lesões Pré-Cancerosas/metabolismo , Lesões Pré-Cancerosas/patologia , Proteínas Serina-Treonina Quinases/biossíntese , Proteínas de Ligação a Telômeros , Proteína 1 de Ligação a Repetições Teloméricas/biossíntese , Proteína 2 de Ligação a Repetições Teloméricas/biossíntese , Proteínas Supressoras de Tumor/biossínteseRESUMO
B-cell chronic lymphocytic leukemia (B-CLL) results in an accumulation of mature CD5(+)/CD23(+) B cells due to an uncharacterized defect in apoptotic cell death. B-CLL is not characterized by a unique recurrent genomic alteration but rather by genomic instability giving rise frequently to several chromosomal aberrations. Besides we reported that approximately 15% of B-CLL patients present malignant B-cells resistant to irradiation-induced apoptosis, contrary to approximately 85% of patients and normal human lymphocytes. Telomere length shortening is observed in radioresistant B-CLL cells. Using fluorescence in situ hybridization (FISH) and multicolour FISH, we tested whether specific chromosomal aberrations might be associated with the radioresistance of a subset of B-CLL cells and whether they are correlated with telomere shortening. In a cohort of 30 B-CLL patients, all of the radioresistant B-CLL cell samples exhibited homozygous or heterozygous deletion of 13q14.3 in contrast to 52% of the radiosensitive samples. In addition to the 13q14.3 deletion, ten out of the 11 radioresistant B-cell samples had another clonal genomic alteration such as trisomy 12, deletion 17p13.1, mutation of the p53 gene or translocations in contrast to only three out of 19 radiosensitive samples. Telomere fusions and non-reciprocal translocations, hallmarks of telomere dysfunction, are not increased in radioresistant B-CLL cells. These findings suggest (i) that the 13q14.3 deletion accompanied by another chromosomal aberration is associated with radioresistance of B-CLL cells and (ii) that telomere shortening is not causative of increased clonal chromosomal aberrations in radioresistant B-CLL cells.
Assuntos
Aberrações Cromossômicas , Leucemia Linfocítica Crônica de Células B/genética , Telômero/genética , Apoptose/efeitos da radiação , Linfócitos B/patologia , Cromossomos Humanos Par 13/genética , Cromossomos Humanos Par 13/efeitos da radiação , Instabilidade Genômica , Humanos , Hibridização in Situ Fluorescente , Leucemia Linfocítica Crônica de Células B/enzimologia , Leucemia Linfocítica Crônica de Células B/patologia , Metáfase , Deleção de Sequência/efeitos da radiação , Telomerase/metabolismo , Telômero/ultraestruturaRESUMO
Primary cultures of isolated rabbit renal proximal cells were grown on collagen-coated permeable supports. The confluent epithelia were polarized, making possible the measurement of uptakes and effluxes across the apical and the basolateral membranes. Uptakes of 65Zn were assessed under initial rate conditions, after 0.5 min incubation. The kinetic parameters of apical uptake were a Jmax of 25.1 +/- 5.3 pmol min-1 (micrograms DNA)-1, a Km of 43.3 +/- 7.3 microM and an unsaturable constant of 0.105 +/- 0.029 (n = 7) at 37 degrees C. Cadmium competitively inhibited the zinc uptake, with a Ki value of 24.5 +/- 7.3 microM. Basolateral uptake was characterized by a high capacity (Jmax = 227.9 +/- 46.6 pmol min-1 (micrograms DNA)-1) and an affinity similar to that of the apical uptake (Km = 35.4 +/- 14.2 microM). Cadmium had no effect on the basolateral zinc uptake. Effluxes across the basolateral face of the epithelium always exceeded those across the apical face. Excess zinc in the culture medium induced the synthesis of metallothionein in the epithelia, as judged by the rate of [35S]cysteine incorporation into a fraction of cytosolic proteins. Metallothionein induction did not appear to modify the kinetic parameters of the apical zinc uptake. These data suggest that separate saturable transport systems are responsible for the apical and basolateral zinc uptakes in proximal renal cells. Induction of metallothionein had no apparent effect on apical zinc uptake in this system.
Assuntos
Túbulos Renais Proximais/metabolismo , Metalotioneína/biossíntese , Zinco/metabolismo , Animais , Cádmio/farmacologia , Membrana Celular/metabolismo , Células Cultivadas , Cisteína/metabolismo , Cinética , Masculino , Coelhos , Radioisótopos de Enxofre , Radioisótopos de ZincoRESUMO
The detection of circulating tumor cells and micrometastases may have important therapeutic and prognostic implications. Telomerase is a hallmark of cancer and is absent from normal epithelial cells. The aim of this study was to use telomerase activity as a molecular marker for the detection of cancer cells in blood of patients with breast cancer. Blood samples were collected from 25 women with stage IV breast cancer and 9 healthy volunteers. Peripheral blood mononuclear cells were isolated by using Ficoll/Hypaque. Immunomagnetic beads coated with an epithelial-specific antibody (BerEP4) were used to harvest epithelial cells from peripheral blood mononuclear cells. Telomerase activity was detected in harvested epithelial cells (HECs) using two different telomerase-PCR-ELISA methods. HECs from blood samples of 21 of 25 (84%) patients with breast cancer were telomerase positive. Telomerase activity was undetectable in HECs from the nine healthy volunteers, demonstrating the specificity of the association between telomerase activity in HECs and stage IV breast cancer. Thus, determination of telomerase activity in HECs appears to be a sensitive, specific, and noninvasive approach for detecting circulating epithelial cancer cells in patients with metastatic breast cancer. This method could be of great value in monitoring the cancer cell proliferation during chemotherapy. This study should be now extended to patients with early-stage breast cancer to investigate the role of telomerase expression by HECs and to evaluate its prognostic value.
Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Proteínas de Neoplasias/sangue , Células Neoplásicas Circulantes/química , Células-Tronco Neoplásicas/enzimologia , Telomerase/sangue , Adulto , Idoso , Neoplasias da Mama/sangue , Neoplasias da Mama/enzimologia , Carcinoma Ductal de Mama/sangue , Carcinoma Ductal de Mama/enzimologia , DNA de Neoplasias/sangue , Ensaio de Imunoadsorção Enzimática , Células Epiteliais/enzimologia , Feminino , Humanos , Separação Imunomagnética , Pessoa de Meia-Idade , Metástase Neoplásica , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/imunologia , Estadiamento de Neoplasias , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Telomerase/genética , Telomerase/imunologiaRESUMO
Telomere length has been proposed as a marker of mitotic cell age and as a general index of human organism aging. Telomere shortening in peripheral blood lymphocytes has been linked to cardiovascular-related morbidity and mortality. The authors investigated the potential correlation of conventional risk factors, radiation dose and telomere shortening with the development of coronary artery disease (CAD) following radiation therapy in a large cohort of Hodgkin lymphoma (HL) patients. Multivariate analysis demonstrated that hypertension and telomere length were the only independent risk factors. This is the first study in a large cohort of patients that demonstrates significant telomere shortening in patients treated by radiation therapy who developed cardiovascular disease. Telomere length appears to be an independent prognostic factor that could help determine patients at high risk of developing CAD after exposure in order to implement early detection and prevention.
Assuntos
Doença da Artéria Coronariana/genética , Doença da Artéria Coronariana/mortalidade , Doença de Hodgkin/radioterapia , Radiometria/estatística & dados numéricos , Radioterapia Conformacional/estatística & dados numéricos , Encurtamento do Telômero/fisiologia , Adolescente , Adulto , Idoso , Bioensaio/métodos , Bioensaio/estatística & dados numéricos , Causalidade , Criança , Estudos de Coortes , Comorbidade , Feminino , Doença de Hodgkin/mortalidade , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Radiometria/métodos , Dosagem Radioterapêutica , Reprodutibilidade dos Testes , Medição de Risco/métodos , Sensibilidade e Especificidade , Taxa de Sobrevida , Encurtamento do Telômero/genética , Adulto JovemRESUMO
BACKGROUND: Circulating tumor cells (CTCs) cannot be readily detected with currently available methods in the majority of patients with prostate cancer. Telomerase activation, one of the major immortalization events, is found in most cases of prostate cancer. We attempted to develop a method using telomerase activity to isolate CTCs in patients with prostate cancer. PATIENTS AND METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood using Ficoll-Hypaque. Immunomagnetic beads coated with an epithelial cell-specific antigen antibody (BerEP4) were used to harvest epithelial cells from PBMCs. Telomerase activity was detected in harvested epithelial cells using the telomerase-PCR-enzyme-linked immunosorbent assay method. RESULTS: Blood samples from 107 patients with prostate cancer were studied. CTCs were detected in 19 of 24 (79%) patients with advanced prostate cancer. In contrast, CTCs were not detected in blood samples from 22 healthy male volunteers. CTCs were even identified in patients with an undetectable (<0.1 ng/ml) serum prostate-specific antigen (PSA). CTCs were detected in 55 of 70 (79%) patients with localized prostate cancer before radical prostatectomy (n = 30) or brachytherapy (n = 40). CTCs were also detected in 3 of 13 patients (23%) with an undetectable serum PSA measured at least 1 year after radical prostatectomy, which is consistent with the expected relapse rate in this setting. CONCLUSION: CTCs can be detected using telomerase activity in a large majority and a wide variety of patients with prostate cancer, including those with localized disease.
Assuntos
Biomarcadores Tumorais/metabolismo , Separação Imunomagnética/métodos , Células Neoplásicas Circulantes/metabolismo , Neoplasias da Próstata/enzimologia , Telomerase/metabolismo , Adulto , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Estudos de Casos e Controles , Diatrizoato , Ensaio de Imunoadsorção Enzimática , Ficoll , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Células Neoplásicas Circulantes/patologia , Reação em Cadeia da Polimerase , Prognóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Telomerase/sangue , Telomerase/genética , Resultado do TratamentoRESUMO
BACKGROUND: Non-small-cell lung cancer arising in never-smokers is usually of adenocarcinoma subtype. The oncogenic pathway of such tumors is poorly understood. To better define the biological characteristics of these tumors, we have compared the expression of a panel of epidermal growth factor receptor (EGFR)-related biomarkers in lung adenocarcinomas from smokers versus those in never-smokers. PATIENTS AND METHODS: Using immunohistochemical analysis, we retrospectively analyzed EGFR, pAKT, PTEN, Ki-67, p27 and hTERT expression in specimens from 190 patients with completely resected lung adenocarcinomas (43 never-smokers and 147 smokers). These analyses were performed on tissue microarrays. RESULTS: EGFR expression was higher in tumors from smokers (P < 0.01), while pAKT was overexpressed mainly in tumors from never-smokers (P = 0.01). As expected, the tumors from smokers presented a higher expression of Ki-67 and a more frequent loss of expression of p27 (P < 0.01). In a multivariate model, two biological factors (p27 and Ki-67) and two clinical factors (age and sex) showed independent significant correlation with never-smoking status. CONCLUSIONS: Lung adenocarcinomas in never-smokers have a very distinct immunohistochemical expression profile of EGFR-related biomarkers as compared with lung adenocarcinomas in smokers. High levels of EGFR and Ki-67 are observed in smokers, while never-smokers are characterized by high levels of pAKT and p27.
Assuntos
Adenocarcinoma/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Pulmonares/metabolismo , Proteínas de Neoplasias/metabolismo , Fumar/metabolismo , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidor de Quinase Dependente de Ciclina p27/metabolismo , Proteínas de Ligação a DNA/metabolismo , Receptores ErbB/metabolismo , Feminino , Humanos , Técnicas Imunoenzimáticas , Antígeno Ki-67/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , PTEN Fosfo-Hidrolase/metabolismo , Prognóstico , Proteínas Proto-Oncogênicas c-akt/metabolismo , Estudos Retrospectivos , Telomerase/metabolismoRESUMO
The aim of this study was to characterize the mechanisms of zinc transport in proximal cells isolated from rabbit kidney cortex. Uptakes of 65Zn were assessed under initial rate conditions, after 0.5 min of incubation. The kinetic parameters obtained at 20 degrees C were a Km of 15.0 +/- 1.5 microM, a Jmax of 208.0 +/- 8.4 pmol min-1 (mg protein)-1, and an unsaturable constant of 0.259 +/- 0.104 (n = 8). Cadmium competitively inhibited the zinc uptake, with a Ki value of 13.0 +/- 2.8 microM, while zinc competitively inhibited 109Cd uptake by isolated cells. Cysteine and histidine stimulated zinc transport at an amino acid:zinc molar ratio ranging from 1:1 to 8:1. This stimulation was not observed in the absence of a sodium gradient. At a molar ratio greater than 16:1 (i.e. 400 microM cysteine or histidine and 25 microM Zn), there was evidence of inhibition. These data suggest that zinc enters renal proximal cells (a) as a free ion via a saturable carrier-mediated process or an unsaturable pathway and (b) complexed with cysteine or histidine, by means of a sodium/amino acid cotransport mechanism.
Assuntos
Túbulos Renais Proximais/metabolismo , Zinco/metabolismo , Animais , Transporte Biológico Ativo/efeitos dos fármacos , Cádmio/metabolismo , Cádmio/farmacologia , Cobre/farmacologia , Cisteína/farmacologia , Histidina/farmacologia , Técnicas In Vitro , Túbulos Renais Proximais/citologia , Túbulos Renais Proximais/efeitos dos fármacos , Cinética , Ligantes , Masculino , CoelhosRESUMO
Alteration of the p16/pRb pathway may cooperate with telomerase activation during cellular immortalization and tumour progression. We studied p16 expression status by immunohistochemistry and telomerase activity using the TRAP assay in 21 premalignant lesions of the head and neck epithelium as well as 27 squamous-cell carcinomas. We also examined expression of other components of the pathway (cyclin D1 and pRb) as well as presence of human papillomavirus genomes which can target these molecules. 4 of 9 mild dysplastic lesions (44%), 8 of 12 moderate/severe dysplastic lesions (67%), and 25 of 27 squamous-cell carcinomas (92%) demonstrated high telomerase activity (P = 0.009). There was a parallel increase with severity of lesions for the trend in proportions of cases demonstrating p16 inactivation or cyclin D1 overexpression (P = 0.02 and P = 0.01, respectively). For Ki67, a marker of cell proliferation, this trend was not significant (P = 0.08). Human papillomavirus infection was only found in 4 cases among the 48 samples tested (8.3%). In conclusion, progression of disease is accompanied by a parallel and continuous increase in telomerase activity and alterations in cell cycle regulators (p16, cyclin D1), as proposed by in vitro models.
Assuntos
Carcinoma de Células Escamosas/genética , Transformação Celular Neoplásica , Regulação Neoplásica da Expressão Gênica , Genes p16/genética , Neoplasias de Cabeça e Pescoço/genética , Telomerase/genética , Adulto , Idoso , Carcinoma de Células Escamosas/enzimologia , Ciclo Celular , DNA de Neoplasias/genética , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Feminino , Neoplasias de Cabeça e Pescoço/enzimologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Papillomaviridae/genética , Reação em Cadeia da Polimerase , Índice de Gravidade de Doença , Telomerase/metabolismoRESUMO
HER-2/neu may play a role in prostate carcinogenesis. The aim of this study was to use the expression of HER-2/neu as a molecular marker for the detection of circulating tumour cells (CTCs) in the blood of patients with prostate cancer (PC). Blood samples were collected from 42 patients with PC and nine healthy volunteers. Immunomagnetic beads were used to harvest epithelial cells from peripheral blood mononuclear cells. Total RNA was extracted and reverse transcribed before analysis by real-time PCR with HER-2/neu-specific primers. CTCs were HER-2/neu positive in six out of 11 (54%) patients with metastatic disease and in three out of 31 (9.6%) patients with localised PC (P=0.004). In blood samples from nine healthy volunteers, we detected no expression of HER-2/neu. The present method appears to be minimally invasive, highly sensitive and a specific approach for detecting CTCs in PC. Furthermore, it may help better target HER-2/neu in advanced PC.
Assuntos
Biomarcadores Tumorais/análise , Regulação Neoplásica da Expressão Gênica , Células Neoplásicas Circulantes/patologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Receptor ErbB-2/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , DNA de Neoplasias , Células Epiteliais , Humanos , Separação Imunomagnética , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Reação em Cadeia da Polimerase , Neoplasias da Próstata/diagnóstico , RNA , Sensibilidade e EspecificidadeRESUMO
Human telomerase reverse transcriptase is a ribonucleoprotein that synthesises telomeric sequences, which decrease at each cell division. In cancer cells, its activity is linked to telomere maintenance leading to unlimited cellular proliferation and immortality. To evaluate the prognostic value of the catalytic subunit telomerase reverse transcriptase (hTERT), we analysed its expression by immunohistochemistry in 122 formalin-fixed lung tumours including 42 squamous cell carcinoma (SCC), 43 adenocarcinoma (ADC), 19 basaloid carcinoma (BC) and 18 small-cell lung carcinoma (SCLC) in comparison with detection of hTERT mRNA by in situ hybridisation and relative telomerase activity by TRAP assay in a subset of tumours. We observed a high concordance between hTERT protein expression and detection of hTERT mRNA and telomerase activity. Telomerase expression varied according to histology (P=0.0002) being significantly lower in ADC than in SCC, BC and SCLC (P<0.0001). Adenocarcinoma and SCC exhibited either a nuclear or a nucleolar staining in contrast with a diffuse nuclear staining observed in most BC and all SCLC (P=0.01). In stage I NSCLC telomerase expression was lower than in other stages (P=0.04), and a nucleolar staining was correlated with a short survival (P=0.03). We concluded that telomerase expression and pattern are distinctive among histopathological classes of lung cancer and convey prognostic influence.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Pequenas/genética , Carcinoma de Células Pequenas/patologia , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias , Telomerase/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Western Blotting , Domínio Catalítico , Proteínas de Ligação a DNA , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Prognóstico , Sensibilidade e Especificidade , Análise de SobrevidaRESUMO
BACKGROUND: The expression of CXCR4 has been implicated in metastatic dissemination in different models of breast cancer and melanoma. In the present study, we evaluated CXCR4 expression in non-small-cell lung cancer (NSCLC) and the relationship between CXCR4 expression and the prognosis of stage I disease. PATIENTS AND METHODS: Using immunohistochemical analysis, we retrospectively analyzed CXCR4 expression in specimens from 61 patients with completely resected pathologically confirmed stage I NSCLC for whom clinical follow-up data were available. RESULTS: In the present study, we have shown that: CXCR4 is expressed by tumor cells in stage I NSCLC; CXCR4 is located in the nucleus and/or in the cytoplasm of tumor cells; strong nuclear staining was observed in 17 cases (29.8%); patients whose tumors had CXCR4-positive nuclear staining had a significantly longer duration of survival than patients whose tumors had no nuclear expression (P = 0.039, log-rank test). Interestingly, the 5-year metastasis rates were 23.5% and 34.1% in patients with CXCR4-positive and CXCR4-negative nuclear expression, respectively (P = 0.2). CONCLUSION: Strong CXCR4-positive nuclear staining was associated with a significantly better outcome in early-stage NSCLC. The mechanisms underlying this clinically and biologically important finding need to be further explored.