title: CXCL12 and CXCR4 in adenocarcinoma of the lung: association with metastasis and survival.
abstract: OBJECTIVE
  Although the chemokine CXCL12 and its receptor CXCR4 have been implicated in metastasis of non-small cell lung carcinoma, the prognostic significance of these molecules is poorly defined. This study aimed to determine whether expression of these molecules is associated with clinicopathologic features and disease-free survival in non-small cell lung carcinoma.
  
  
  METHODS
  Immunohistochemical staining for CXCL12 and CXCR4 was performed on 154 primary non-small cell lung carcinomas. Staining intensity was compared with tumor histotype, TNM stage, and disease-free survival; correlation was assessed by using the Fisher's exact test, and Kaplan-Meier and Cox multivariate proportional hazards regression analysis.
  
  
  RESULTS
  Intense CXCL12 immunostaining was associated with nodal metastasis, although no difference in survival was observed. The prognostic relevance of CXCR4 was dependent on its subcellular location: in univariate analysis intense nuclear staining was significantly associated with lower T classification and improved disease-free survival in patients with adenocarcinoma, whereas cytomembranous staining was associated with distant metastasis and decreased disease-free survival. On multivariate analysis, cytomembranous CXCR4 expression conferred a significantly worse disease-free survival (relative risk, 2.8; 95% confidence interval, 1.4-5.7; P = .004).
  
  
  CONCLUSIONS
  Cytomembranous expression of the chemokine receptor CXCR4 in adenocarcinoma of the lung is an independent risk factor associated with worse disease-free survival, whereas nuclear staining confers a survival benefit. These findings are consistent with a model in which CXCR4 promotes tumor cell proliferation and metastasis when present in the cytoplasm or cell membrane, whereas localization of this molecule in the nucleus prevents it from exerting these effects.
authors.affiliation: Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10021, USA. plw9001@nyp.org
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Wagner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hyjek
authors.forename: Madeline F
authors.initials: MF
authors.lastname: Vazquez
authors.forename: Danish
authors.initials: D
authors.lastname: Meherally
authors.forename: Yi Fang
authors.initials: YF
authors.lastname: Liu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Chadwick
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rengifo
authors.forename: Gabriel L
authors.initials: GL
authors.lastname: Sica
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Port
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lee
authors.forename: Subroto
authors.initials: S
authors.lastname: Paul
authors.forename: Nasser K
authors.initials: NK
authors.lastname: Altorki
authors.forename: Anjali
authors.initials: A
authors.lastname: Saqi
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000378:metabolism* / Q000401:mortality* / Q000556:secondary*; D000368:Aged; D054377:Chemokine CXCL12 / Q000032:analysis / Q000096:biosynthesis*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000737:chemistry / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D008297:Male; D019718:Receptors, CXCR4 / Q000032:analysis / Q000096:biosynthesis*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: C527276:CXCR4 protein, human; D054377:Chemokine CXCL12; D019718:Receptors, CXCR4