title: [Expression of Cdx-2 homeobox gene in intestinal metaplasia and gastric adenocarcinoma].
abstract: OBJECTIVE
  The Cdx-1 and Cdx-2 genes are intestinal transcription factors that may be involved in the regulation of proliferation and differentiation of intestinal epithelial cells. The Cdx-1 and Cdx-2 are expressed in the epithelium of the small intestine and colon but not in the normal epithelium of the esophagus and stomach. Conversely, aberrant Cdx-2 expression is often observed in the esophagus and stomach. We investigated the expression and role of Cdx-2 in intestinal metaplasia and gastric adenocarcinoma.
  
  
  METHODS
  The gastric tissues obtained endoscopically were analyzed by the reverse transcriptase-polymerase chain reaction and histology. The Cdx-1 and Cdx-2 mRNA expression was confirmed and analyzed according to updated Sydney classification. Then, immunohistochemical study with monoclonal anti-Cdx-2 antibody was performed with gastric adenocarcinoma obtained by surgical resection.
  
  
  RESULTS
  The prevalence of Cdx-1 and Cdx-2 mRNA expression was significantly higher in mucosa with intestinal metaplasia than mucosa without intestinal metaplasia. In immunohistochemical study, nuclear staining of Cdx-2 was strong in metaplastic mucosa, but weak in adjacent normal gastric mucosa (p<0.001). The expression of Cdx-2 in gastric adenocarcinoma was lower than in metaplastic mucosa (p<0.001). The Cdx-2 expression was also detected in 97% of intestinal type gastric adenocarcinoma and 61.5% of diffuse type gastric adenocarcinoma (p=0.003).
  
  
  CONCLUSIONS
  Aberrant expression of Cdx-2 is observed in intestinal metaplasia and a subset of gastric adenocarcinoma, which is predominant in intestinal-type gastric adenocarcinoma. Therefore, Cdx-2 may play an important role in gastric carcinogenesis, especially in intestinal type adenocarcinoma.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Paik
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Chung
authors.forename: Jong Pyo
authors.initials: JP
authors.lastname: Kim
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Hahm
authors.forename: Young Ha
authors.initials: YH
authors.lastname: Oh
authors.forename: Yong Uk
authors.initials: YU
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000378:metabolism; D000328:Adult; D000368:Aged; D000071616:CDX2 Transcription Factor; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D015870:Gene Expression; D005801:Genes, Homeobox / Q000235:genetics*; D018398:Homeodomain Proteins / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000235:genetics* / Q000378:metabolism; D015534:Trans-Activators
chemical_list: D000071616:CDX2 Transcription Factor; D018398:Homeodomain Proteins; D015534:Trans-Activators