Summary Tumours develop through the accumulation of genetic alterations associated with a progressive increase of the malignant phenotype. In lung cancer, chronic exposure of bronchial epithelium to carcinogens in cigarette smoke may lead to multiple dysplastic and hyperplastic lesions scattered throughout the tracheobronchial tree. Little is known about the genetic alterations in such lesions. This study was carried out to examine cyclin Dl (CCND1) and retinoblastoma (RB1) gene expression in the bronchial epithelium of patients with lung cancer. Lung tumours and their corresponding tumour-free resection margins from 33 patients who underwent resection of non-small-cell lung cancer (NSCLC) were examined by immunostaining with monoclonal antibodies against cyclin Dl (DCS-6; Novocastra) and pRb (NCL Rb-1; Novocastra). Examination of the resection margins revealed four carcinomas in situ, 19 hyperplasias and ten sections showing apparently normal bronchial epithelium. A control group of patients, without lung tumours and who had never smoked, revealed no or weak cyclin Dl and positive pRb staining within bronchial epithelia. Increased cyclin Dl and diminished pRb expression were found in 76% (n = 25) and 27% (n = 9) of the resection margins respectively, and in 12% (n = 4) both cyclin Dl and pRb expression were altered. In the corresponding tumours, 48% (n = 16) were normal, while altered expression was found for cyclin Dl in 33% (n = 11), pRb in 27% (n = 9) and both in 9% (n = 3) of cases. It appears that altered expression of cyclin Dl and pRb is an early event in NSCLC development in almost half of cases analysed. Further investigations are needed to determine the significance of immunostaining of bronchial specimens in individuals at risk of lung cancer, with the possibility that the observations are of importance in the early diagnosis of NSCLC.Keywords: non-small-cell lung cancer; carcinogenesis; cyclin D1; CCND1; retinoblastoma protein; RB1; carcinoma in situ Lung cancer has become a worldwide problem with a greater than tenfold increase in incidence of reported disease since 1930. Chronic exposure to bronchial irritants appears to lead to epithelial changes, scattered throughout the tracheobronchial tree (Auerbach et al, 1962a(Auerbach et al, ,b, 1975. Patients with lung cancer have a much greater frequency of epithelial hyperplasia in main bronchi (>90%) compared with patients (10%) who have never smoked (Auerbach et al, 1961). The best evidence for an association between carcinoma in situ and invasive carcinoma probably comes from sputum cytology from uranium miners, which showed increasingly abnormal epithelial cells as the patients progressed towards invasive lung tumours (Saccomanno et al, 1974). These results suggest that the whole tracheobronchial tree is affected by carcinogen exposure. Cells with genetic lesions resulting in a growth advantage are likely to replace the epithelium of the whole tracheobronchial tree and, in the case of additional genetic events, may show invasive growth (Thibervill...