Expression of Cdx2 and the phenotype of advanced gastric cancers: relationship with prognosis.
OBJECTIVE
The clinicopathologic significance of the phenotype and Cdx2 expression has hitherto remained unclear in gastric cancers. In the present study, we therefore examined the correlation between prognosis, phenotype, and Cdx2 expression in advanced cases.


METHODS
We evaluated 177 advanced gastric carcinomas histologically and phenotypically. The expression of Cdx2 was also assessed by immunohistochemistry.


RESULTS
The lesions were phenotypically divided into 32 gastric (G type), 36 gastric and intestinal mixed (GI type), 53 intestinal (I type), and 56 null (N type) types, independent of the histological classification. Cdx2 nuclear staining demonstrated a close relation to intestinal phenotypic expression, not with the histological classification. Kaplan-Meier analysis of Cdx2 expression and the phenotype showed that the Cdx2 positive groups had a significantly better outcome than the negative ones (P=0.0013), and the patients with GI type cancers had significant better survival than those with N type (P=0.0052).


CONCLUSIONS
Our results suggest that Cdx2 is a useful prognostic marker. In addition, advanced gastric cancers with both intestinal and gastric phenotypic expression have a relatively good prognosis. Combined evaluation of gastric and intestinal epithelial cell markers, including Cdx2, is clinically useful to predict outcome in patients with advanced neoplasm of the stomach.
Mizoshita
Tsutomu
T
Division of Oncological Pathology, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, 464-8681 Nagoya, Japan.
Tsukamoto
Tetsuya
T
Nakanishi
Hayao
H
Inada
Ken-ichi
K
Ogasawara
Naotaka
N
Joh
Takashi
T
Itoh
Makoto
M
Yamamura
Yoshitaka
Y
Tatematsu
Masae
M
D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D000071616:CDX2 Transcription Factor; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D013274:Stomach Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors; D015534:Trans-Activators
D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; D018398:Homeodomain Proteins; D009363:Neoplasm Proteins; D015534:Trans-Activators