Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Nov 27, 2011; 3(11): 159-166
Published online Nov 27, 2011. doi: 10.4240/wjgs.v3.i11.159
CDX2 as a marker for intestinal differentiation: Its utility and limitations
Reda S Saad, Zeina Ghorab, Mahmoud A Khalifa, Mei Xu
Reda S Saad, Zeina Ghorab, Mahmoud A Khalifa, Department of Pathobiology, Sunnybrook Health Sciences Center, University of Toronto, Ontario, ON M4N 3M5, Canada
Mei Xu, Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, ON M4N 3M5, Canada
Author contributions: All authors contributed to this review.
Correspondence to: Reda S Saad, MD, PhD, FRCPC, Associate Professor, Department of Pathobiology, Rm E403, Sunnybrook Health Sciences Center, 2075 Bayview Avenue, Toronto, Ontario, ON M4N 3M5, Canada. reda.saad@sunnybrook.ca
Telephone: +1-416-4804011 Fax: +1-416-4804271
Received: September 21, 2011
Revised: November 3, 2011
Accepted: November 10, 2011
Published online: November 27, 2011
Abstract

CDX2 is a nuclear homeobox transcription factor that belongs to the caudal-related family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play an essential role in the control of normal embryonic development. CDX2 is crucial for axial patterning of the alimentary tract during embryonic development and is involved in the processes of intestinal cell proliferation, differentiation, adhesion, and apoptosis. It is considered specific for enterocytes and has been used for the diagnosis of primary and metastatic colorectal adenocarcinoma. CDX2 expression has been reported to be organ specific and is normally expressed throughout embryonic and postnatal life within the nuclei of epithelial cells of the alimentary tract from the proximal duodenum to the distal rectum. In this review, the authors elaborate on the diagnostic utility of CDX2 in gastrointestinal tumors and other neoplasms with intestinal differentiation. Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed.

Keywords: CDX2, Colorectal carcinoma, Aberrant expression