title: CDX-2 homeobox gene expression in human gastric carcinoma and precursor lesions.
abstract: BACKGROUND
  Recent studies have demonstrated that CDX-2 is expressed in the intestinal metaplasia of the stomach and intestinal-type gastric cancer. To address the role of CDX-2 in carcinogenesis of gastric carcinomas of intestinal type, the expression of CDX-2 in gastric carcinoma and precursor lesions were examined using immunohistochemistry.
  
  
  METHODS
  A total of 160 specimens diagnosed as gastric carcinomas or non-invasive neoplasia from 158 patients were analyzed for CDX-2 expression by immunochemical methods. Patients were classified into histopathologic subgroups according to the Padova international classification: 60 cases of low-grade non-invasive neoplasia, 55 cases of high grade, and 45 cases of invasive intestinal-type adenocarcinoma. The CDX-2 expression in non-neoplastic gastric mucosa including intestinal metaplasia was also evaluated in the areas included in the histologic sections.
  
  
  RESULTS
  The CDX-2 expression was localized in the epithelial cell nuclei in the area of intestinal metaplasia with or without dysplasia and carcinoma, consistent with its role as a transcriptional regulator. No CDX-2 reactivity was noted in the normal mucosa in all cases. The CDX-2 expression was detected in 73.3% of low-grade cases, 85.5% of high-grade cases and 91.1% of intestinal-type adenocarcinoma cases. In the gastric mucosa with intestinal metaplasia, 89.7% of the samples were positive. The CDX-2-expressing cells in intestinal metaplasia were more prevalent than in dysplasia and carcinoma. Expression of CDX-2 showed a statistically significant positive correlation with increasing grade of dysplasia and carcinoma.
  
  
  CONCLUSIONS
  These findings suggest that CDX-2 expression in stomach cancer may be a marker of the progression of gastric carcinogenesis, and that its activation may represent an early event.
authors.affiliation: Department of Pathology, Seonam University, College of Medicine, Korea.
authors.forename: Hyung-Seok
authors.initials: HS
authors.lastname: Kim
authors.forename: Ji-Shin
authors.initials: JS
authors.lastname: Lee
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Freund
authors.forename: Kyung-Whan
authors.initials: KW
authors.lastname: Min
authors.forename: Jeong-Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Wan
authors.initials: W
authors.lastname: Kim
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Juhng
authors.forename: Chang-Soo
authors.initials: CS
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D014408:Biomarkers, Tumor; D001706:Biopsy; D000071616:CDX2 Transcription Factor; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology*; D015972:Gene Expression Regulation, Neoplastic; D018398:Homeodomain Proteins / Q000096:biosynthesis / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D004273:DNA, Neoplasm; D018398:Homeodomain Proteins