CDX-2 homeobox gene expression in human gastric carcinoma and precursor lesions

• Published in: Journal of gastroenterology and hepatology 2006-02, Vol.21 (2), p.438-442
• Main Authors: KIM, HYUNG-SEOK, LEE, JI-SHIN, FREUND, JEAN-NOEL, MIN, KYUNG-WHAN, LEE, JEONG-SOO, KIM, WAN, JUHNG, SANG-WOO, PARK, CHANG-SOO
• Format: Article
• Language: English
• Subjects: adenocarcinoma; Adenocarcinoma - genetics; Adenocarcinoma - metabolism; Adenocarcinoma - pathology; Aged; Biological and medical sciences; Biomarkers, Tumor; Biopsy; CDX-2; CDX2 Transcription Factor; Cellular Biology; DNA, Neoplasm - genetics; Female; Gastric Mucosa - metabolism; Gastric Mucosa - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Gene Expression Regulation, Neoplastic; Homeodomain Proteins - biosynthesis; Homeodomain Proteins - genetics; Humans; Immunohistochemistry; Life Sciences; Male; Medical sciences; Middle Aged; non-invasive neoplasia; Precancerous Conditions - genetics; Precancerous Conditions - metabolism; Precancerous Conditions - pathology; Prognosis; Retrospective Studies; stomach; Stomach Neoplasms - genetics; Stomach Neoplasms - metabolism; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2005.03933.x

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. © 2005 Blackwell Publishing Asia Pty Ltd