Association of CDX2 and mucin expression with chemotherapeutic benefits in patients with stage II / III gastric cancer

BackgroundBetter predictors of patients with stage II/III gastric cancer (GC) most likely to benefit from adjuvant chemotherapy are urgently needed. This study aimed to assess the ability of CDX2 and mucin markers to predict prognosis and fluorouracil-based adjuvant chemotherapy benefits.MethodsCDX2...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) MA), 2023-09, Vol.12 (17), p.17613-17631
Main Authors: Gao, Xianchun, Han, Weili, Chen, Ling, Li, Hongwei, Zhou, Fenli, Bai, Bin, Yan, Junya, Guo, Yong, Liu, Kun, Li, Wenjiao, Li, Renlong, Yuan, Qiangqiang, Zhang, Jiehao, Lu, Yuanyuan, Zhao, Xiaodi, Ji, Gang, Li, Mengbin, Zhao, Qingchuan, Wu, Kaichun, Li, Zengshan, Nie, Yongzhan
Format: Article
Language:English
Subjects:
5-Fluorouracil
adjuvant chemotherapy
Antibodies
Cancer therapies
CDX2
CDX2 protein
Chemotherapy
Cloning
Colorectal cancer
Gastric cancer
Genotype & phenotype
Hospitals
Immunohistochemistry
Medical prognosis
Medical research
mRNA
Mucin
Patients
Prognosis
Risk factors
Surgery
Survival
Tumors
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Summary:BackgroundBetter predictors of patients with stage II/III gastric cancer (GC) most likely to benefit from adjuvant chemotherapy are urgently needed. This study aimed to assess the ability of CDX2 and mucin markers to predict prognosis and fluorouracil-based adjuvant chemotherapy benefits.MethodsCDX2 and mucin protein expressions were examined by immunohistochemistry and compared with survival and adjuvant chemotherapy benefits in a prospective evaluation cohort of 782 stage II/III GC patients. Then, the main findings were validated in an independent validation cohort (n = 386) and an external mRNA sequencing dataset (ACRG cohort, n = 193).ResultsIn the evaluation cohort, CDX2, CD10, MUC2, MUC5AC, and MUC6 expressions were observed in 59.7%, 26.7%, 27.6%, 55.1%, and 57.7% of patients, respectively. However, only the expression of CDX2 was found to be associated with adjuvant chemotherapy benefits. Most importantly, CDX2-negative patients had a poorer prognosis when treated with surgery only, while the prognosis of CDX2-negative and CDX2-positive patients was similar when receiving postoperative adjuvant chemotherapy. Further analysis revealed that patients with CDX2 negative tumors benefited from chemotherapy (5-year overall survival rates: 60.0% with chemotherapy vs. 23.2% with surgery-only, p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.6379