Purpose: The Int6 gene was originally identified as a common insertion site for the mouse mammary tumor virus in virally induced mouse mammary tumors. Recent studies indicate that Int6 is a multifaceted protein involved in the regulation of protein translation and degradation through binding with three complexes: the eukaryotic translation initiation factor 3, the proteasome regulatory lid, and the constitutive photomorphogenesis 9 signalosome. This study aimed to investigate the prognostic role of Int6 in a large series of stage I non^small cell lung cancers (NSCLC) patients with long-term follow-up. Experimental Design: We determined the methylation status of Int6 DNA by methylationspecific PCR and the steady-state levels of Int6 RNA by quantitative real-time reverse transcription-PCR in 101 NSCLCs and matched normal lung tissues. Results: In 27% of the tumors, Int6 RNA levels were reduced relative to normal tissue. In 85% of the tumors with reduced Int6 expression, the transcription promoter and first exon were hypermethylated, whereas only 4% of the tumors with elevated Int6 RNA levels were hypermethylated (P < 0.000001). Low levels of Int6 RNA were found a significant predictor of overall and disease-free survival (P = 0.0004 and P = 0.0020, respectively). A multivariate analysis confirmed that low Int6 expression was the only independent factor to predict poor prognosis, for both overall (P = 0.0006) and disease-free (P = 0.024) survival. Conclusions: Our results suggest that Int6 expression, evaluated by quantitative real-time PCR, may represent a new prognostic factor in patients with stage I NSCLC.The Int6 gene was first identified as a common insertion site for mouse mammary tumor virus in virally induced mouse mammary tumors and a preneoplastic lesion (1). In each case, mouse mammary tumor virus integrated into an intron in the opposite transcriptional orientation of Int6. Transcription of the affected allele was terminated at a cryptic transcription stop signal in the reverse mouse mammary tumor virus long terminal repeat sequence causing the expression of a truncated chimeric RNA that encodes a COOH-terminally deleted product. Overexpression of these truncated proteins can confer the capability of anchorage-independent growth on mammary epithelial cells and fibroblasts in culture and injection of these cells into nude mice can lead to tumor development (2, 3). Because we found no mutations in the remaining allele of the mouse mammary tumor virus -induced tumors, we have hypothesized that the truncated Int6 protein may act as dominant-negative oncoprotein.The Int6 gene has been highly conserved through evolution, from fission yeast to humans, with the intriguing exception of budding yeasts that have a related protein called Pci8p (4). Int6 was later independently rediscovered several times by investigators working in different areas of biological research (5). Asano et al. found that Int6 is identical to the p48 subunit of the eukaryotic translation initiation factor3 (eIF3) complex that pla...