Expression and significance of homeodomain protein Cdx2 in gastric carcinoma and precancerous lesions.
OBJECTIVE
To investigate the expression and significance of caudal-related homeobox transcription factor (Cdx2) in gastric carcinoma (GC) and precancerous lesions.


METHODS
The expression of Cdx2 in GC, precancerous lesions and normal gastric mucosa were detected using immunohistochemical method. Hematoxylin and eosin staining, alcian blue/periodic acid-schiff and high iron diamine/alcian blue staining were used to classify intestinal metaplasia (IM) and GC.


RESULTS
Cdx2 was not detected in normal gastric mucosa. Cdx2 expression was detected in 87.1% (101/116) of IM, 50% (36/72) of dysplasia and 48.2% (41/85) of GC. The Cdx2-expressing cells in IM were more prevalent than in dysplasia and carcinoma (P < 0.05). There was no relationship between Cdx2 expression and the classification of IM or the degree of dysplasia. Expression of Cdx2 was significantly higher in intestinal-type carcinoma than in diffuse and mixed-type carcinoma (P < 0.05). Positive expression of Cdx2 was mainly found in moderately to well differentiated GC. There was a negative association between nuclear Cdx2 expression and lymph node metastasis and tumor, nodes, metastasis stage of GC (P < 0.05). The patients with Cdx2-positive expression showed a higher survival rate than those with Cdx2-negative expression (P = 0.038). Multivariate analysis revealed that the expression of Cdx2 and lymph node metastasis were independent prognostic indicators of GC (P < 0.05).


CONCLUSIONS
Cdx2 may be closely related to IM and the intestinal-type GC and implicate better biological behavior and outcome. Cdx2 is useful for predicting the prognosis of GC.
Department of Pathology, Basic Medical College, Anhui Medical University, Hefei 230032, Anhui Province, China. rongqincn@yahoo.com.cn
Rong
R
Qin
Na-Na
NN
Wang
Jing
J
Chu
Xian
X
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D000071616:CDX2 Transcription Factor; D002277:Carcinoma / Q000737:chemistry* / Q000401:mortality / Q000556:secondary; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D018398:Homeodomain Proteins / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D055815:Young Adult
D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins