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Serum levels of CCL5 were measured using a cytometric bead\u2010based immunoassay kit and CCL5 expression in cancer cells was determined using immunohistochemical staining. In addition, mRNA in cancer and stromal cells was analyzed by microdissection and comparison with the public dataset. Disease\u2010free survival (DFS) of patients with high CCL5 levels (cut\u2010off, 13.87\u00a0ng\/mL; n\u00a0=\u00a0192) was significantly better than those with low CCL5 levels (n\u00a0=\u00a058; hazard ratio, 0.20; 95% confidence interval, 0.10\u20100.39; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). An improved overall survival was observed in patients with high CCL5 levels compared to those with low CCL5 levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.024). On the contrary, high immunohistochemical expression of CCL5 in cancer cells was significantly associated with decreased DFS. As serum CCL5 levels did not correlate with CCL5 expression in cancer cells and the relative expression of mRNA <jats:italic>CCL5<\/jats:italic> was elevated in stromal cells in relation to cancer cells, serum CCL5 might be derived not from cancer cells, but from stromal cells. Expression of CCL5 in serum, but not in cancer cells, might contribute to improved patient prognosis mediating through not only immune reaction, but through other mechanisms. Determination of circulating CCL5 levels could be useful for predicting patient prognosis.<\/jats:p>","DOI":"10.1111\/cas.14234","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T09:01:26Z","timestamp":1573722086000},"page":"209-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Significant association between high serum CCL5 levels and better disease\u2010free survival of patients with early breast cancer"],"prefix":"10.1111","volume":"111","author":[{"given":"Yukie","family":"Fujimoto","sequence":"first","affiliation":[{"name":"Division of Breast and Endocrine Surgery Department of Surgery Hyogo College of Medicine Nishinomiya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuko","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Breast and Endocrine Surgery Department of Surgery Hyogo College of Medicine Nishinomiya 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