Aberrant expression of CDX2 in the gastric mucosa with and without intestinal metaplasia: effect of eradication of Helicobacter pylori.
BACKGROUND
The intestine-specific transcription factor CDX2 plays an important role in differentiation and maintenance of intestinal epithelial cells. Development and progression of intestinal metaplasia (IM) in the stomach is closely associated with Helicobacter pylori-gastritis. We investigated expression of CDX2 protein in the gastric mucosa with and without IM before and after eradication of H. pylori.


METHODS
The subjects comprised five normal controls and 29 H. pylori-positive patients (15 with antral IM and 14 without IM), who were followed for 12 months after eradication of H. pylori. Biopsies were taken from the greater curvatures of the antrum and middle body. Expression of CDX2 was evaluated immunohistochemically using anti-CDX2 antibody.


RESULTS
CDX2 expression was not found in controls. Strong nuclear staining was observed extensively in IM, but rarely in the gastric epithelium, except for the focal area in only four antral biopsies (three with and one without IM). Fine granular cytoplasmic staining was also observed in the perinuclear regions of IM and the gastric epithelial cells in half of the patients. In 13 of the 15 patients with IM, IM did not regress after eradication of H. pylori, and the extent of nuclear staining in IM did not change. The extent of cytoplasmic staining did not change either.


CONCLUSIONS
Our results indicate that CDX2 expression in the gastric mucosa is found in patients with chronic gastritis and is closely associated with IM. CDX2 expression in IM or the gastric epithelial cells did not disappear after eradication of H. pylori.
Satoh
Kiichi
K
Division of Gastroenterology, Department of Internal Medicine, Jichi Medical School, Tochigi, Japan.
Mutoh
Hiroyuki
H
Eda
Akashi
A
Yanaka
Ichiro
I
Osawa
Hiroyuki
H
Honda
Sayaka
S
Kawata
Hiroshi
H
Kihira
Ken
K
Sugano
Kentaro
K
D000328:Adult; D000368:Aged; D000071616:CDX2 Transcription Factor; D016022:Case-Control Studies; D005260:Female; D005756:Gastritis / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016480:Helicobacter pylori; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000378:metabolism* / Q000382:microbiology; D008875:Middle Aged; D015534:Trans-Activators
D000071616:CDX2 Transcription Factor; D018398:Homeodomain Proteins; D015534:Trans-Activators