SUMMARY:Radixin is a member of the ERM (ezrin/radixin/moesin) protein family that is proposed to function as a membrane-cytoskeletal linker. Using differential display analysis, we have identified radixin as a gene down-regulated in primary lung adenocarcinoma. Real-time quantitative reverse transcription polymerase chain reaction confirmed that radixin mRNA was decreased, both in 10 early-stage bronchioloalveolar carcinomas and in 16 invasive lung adenocarcinomas, by 69% (p ϭ 0.0002) and 82% (p Ͻ 0.0001), respectively, compared with 9 nontumor lung tissues. Similarly, moesin and ezrin mRNA levels were reduced in lung adenocarcinoma. Immunohistochemistry confirmed that cancer cells expressed very little radixin and moesin, whereas non-neoplastic alveolar and bronchiolar epithelial cells, and endothelial cells, including those within the tumor stroma, were consistently positive for these two proteins. Ezrin was localized in the apical surface of non-neoplastic bronchiolar and alveolar epithelial cells and, in contrast to radixin and moesin, the majority of tumor cells retained expression of ezrin. Localization of ezrin was altered in a significant proportion of tumor cells: whereas tumor cells forming lumina displayed membranous staining on the apical side, tumor cells with disorganized structures were either negative or diffusely positive for ezrin in the cytoplasm. Furthermore, a fraction of tumor cells invading the stroma in a scattered manner were strongly positive for ezrin. In conclusion, expression of radixin and moesin is down-regulated in lung adenocarcinoma, including early-stage bronchioloalveolar carcinoma. An intriguing implication of this finding is that these two genes may function as tumor suppressors in lung adenocarcinoma oncogenesis. Although structurally related to radixin and moesin, ezrin may have a distinct function in tumor-cell invasion. (Lab Invest 2000, 80:1643-1650.O f the various malignant tumors, lung cancer is the most common cause of cancer death worldwide. However the biological behavior of lung cancer is not fully characterized, and the outcome of surgical treatment remains unsatisfactory. Identification of genes that are involved in tumorigenesis and in the progression of lung cancer will be required to formulate more effective therapies. One approach to the identification of such genes is to use differential display analysis (Bauer et al, 1993;Liang et al, , 1993Sager et al, 1993;Yoshikawa et al, 1998).Radixin is a member of the ERM (ezrin/radixin/ moesin) family of proteins (Mangeat et al, 1999;Sato et al, 1992), which was first isolated as a constituent of adherence junctions in rat liver (Tsukita and Hieda, 1989). Ezrin was first purified as a component of intestinal microvilli that is tyrosine-phosphorylated by epidermal growth factor receptor (EGFR; Bretscher, 1989), and moesin was originally identified as a heparin-binding protein (Lankes and Furthmayr, 1991). The amino-terminal half of the ERM protein is about 85% homologous, whereas homology in the carboxy-terminal hal...