title: The role of CXCR4 in the prediction of bone metastases from breast cancer: a pilot study.
abstract: OBJECTIVE
  The chemokine receptor CXCR4 is involved in tumor growth and homing of cancer cells to distant sites. The aim of our retrospective case-control study was to evaluate whether CXCR4 expression is more effective than conventional markers (estrogen receptor and HER-2) in predicting bone relapse in breast cancer.
  
  
  METHODS
  CXCR4 expression was evaluated by immunohistochemical staining in paraffin-embedded tissue sections of primary breast cancers from 20 patients with bone metastases (BM), 10 with visceral metastases (VM) and 10 with no evidence of disease (NED) at a median follow-up of 10.5 years (range 10.1-11.8).
  
  
  RESULTS
  Cytoplasmic CXCR4 expression was high in BM patients (45%, 95% CI 23-67), much lower in NED patients (10%, 95% CI 0-29) and negative in the VM group. CXCR4 coexpression in the nucleus and cytoplasm was observed in about half of the BM patients (45%) but never in NED or VM patients (p = 0.013). Conversely, estrogen receptor-positive and HER-2-negative status identified 80 and 95% of bone relapse patients, respectively, but did not discriminate between cases and controls.
  
  
  CONCLUSIONS
  Our results suggest a pivotal role of CXCR4 expression as a predictor of BM in primary breast cancer. A larger study is ongoing to confirm these results.
authors: Osteoncology Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy. e.sacanna@irst.emr.it
authors: Emanuele
authors: E
authors: Sacanna
authors: Toni
authors: T
authors: Ibrahim
authors: Michele
authors: M
authors: Gaudio
authors: Laura
authors: L
authors: Mercatali
authors: Emanuela
authors: E
authors: Scarpi
authors: Wainer
authors: W
authors: Zoli
authors: Patrizia
authors: P
authors: Serra
authors: Sara
authors: S
authors: Bravaccini
authors: Rossana
authors: R
authors: Ricci
authors: Luigi
authors: L
authors: Serra
authors: Dino
authors: D
authors: Amadori
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D001859:Bone Neoplasms / Q000378:metabolism* / Q000556:secondary*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D018734:Genes, erbB-2; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010865:Pilot Projects; D019718:Receptors, CXCR4 / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D019718:Receptors, CXCR4; D011960:Receptors, Estrogen