title: Immunohistochemically detectable Cdx2 is present in intestinal phenotypic elements in early gastric cancers of both differentiated and undifferentiated types, with no correlation to non-neoplastic surrounding mucosa.
abstract: It has previously been reported that Cdx2 is the useful prognostic and intestinal phenotypic marker in advanced gastric cancers (GC). In this study, Cdx2 expression and phenotype in early GC and non-neoplastic surrounding mucosa were examined. A total of 130 early GC (70 intramucosal and 60 submucosally invasive cancers) histologically and phenotypically were evaluated. The expression of Cdx2 was assessed by immunohistochemistry. The lesions were phenotypically divided into 44 gastric (G), 42 gastric and intestinal mixed (GI), 30 intestinal (I), and 14 null (N) types, independent of the histological classification. Most of the early GC were Cdx2-positive, nuclear staining being strongly associated with intestinal phenotypic expression. Early differentiated cancers tended to feature both Cdx2 and intestinal phenotypic expression, while their undifferentiated counterparts were more likely to demonstrate only gastric phenotypic expression (P < 0.05). The phenotypes of six intramucosal microcarcinomas did not correlate with those of adjacent normal glands. These data suggest that Cdx2 is expressed in the very early stage of gastric carcinogenesis in association with the shift from gastric to intestinal phenotypic expression. This appears to occur in differentiated cancers at an earlier stage than in undifferentiated ones, and may be linked to suppression of expansion of malignant cells.
authors.affiliation: Division of Oncological Pathology, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Mizoshita
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Inada
authors.forename: Naotaka
authors.initials: N
authors.lastname: Ogasawara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirata
authors.forename: Sosuke
authors.initials: S
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
authors.forename: Makoto
authors.initials: M
authors.lastname: Itoh
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Masae
authors.initials: M
authors.lastname: Tatematsu
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D000071616:CDX2 Transcription Factor; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005753:Gastric Mucosa / Q000378:metabolism* / Q000473:pathology; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009077:Mucins; D010641:Phenotype; D013274:Stomach Neoplasms / Q000145:classification / Q000378:metabolism* / Q000473:pathology
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; D009077:Mucins; C042384:gastro-intestinal mucus-associated antigens