Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2012; 18(25): 3296-3302
Published online Jul 7, 2012. doi: 10.3748/wjg.v18.i25.3296
Expression and significance of homeodomain protein Cdx2 in gastric carcinoma and precancerous lesions
Rong Qin, Na-Na Wang, Jing Chu, Xian Wang
Rong Qin, Na-Na Wang, Jing Chu, Xian Wang, Department of Pathology, Basic Medical College, Anhui Medical University, Hefei 230032, Anhui Province, China
Author contributions: Qin R designed the study and wrote the manuscript; Wang NN and Chu J performed the majority of experiments; Wang X coordinated the study performance and collected all the human materials.
Supported by The Natural Science Foundation of Anhui Province, No. 090413118
Correspondence to: Dr. Rong Qin, Department of Pathology, Basic Medical College, Anhui Medical University, 69 Meishan Road, Hefei 230032, Anhui Province, China.
Telephone: +86-551-3869490 Fax: +86-551-3869490
Received: September 17, 2011
Revised: November 15, 2011
Accepted: March 19, 2012
Published online: July 7, 2012

AIM: 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).

CONCLUSION: 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.

Keywords: Caudal-related homeobox transcription factor, Stomach neoplasm, Intestinal metaplasia, Dysplasia, Immunohistochemistry