Expression and Significance of CDX2 Protein in Intestinal Metaplasia and Gastric Carcinoma

Objective To investigate the expression of CDX2 in the gastric carcinoma(GC) and gastric intestinalmetaplasia(IM) and its significance.Methods By immunohistochemistry,CDX2 expression were tested in surgically dissected GC tissues from 49 patients,normal gastric mucosa tissues from 29 patients and gastric IM tissues from 20 patients.Tumor cell proliferation rate in GCs were evaluated by the detection of Ki-67 expression.Results CDX2 was not expressed in the normal gastric mucosa.The positive expression rate of CDX2 was 90.0%(18/20) in IM and 59.1%(29/49) in GC,showing a significant difference between the two groups(P=0.013).CDX2 expression was also markedly different between intestinal-type GC and diffuse-type GC(73.5% v.s.(26.7%),P=0.002).A negative association was observed between the index for CDX2 and Ki-67 immunostaining(γs =-0.448,P=0.001),indicating a low cell proliferation rate in GC with high CDX2 index.The expression of CDX2 was positively correlated with TNM stage(γs=-0.482,P0.001)and tumor differentiation(γs=0.591,P0.001),but negatively correlated with lymph node metastasis(γs=-0.382,P=0.012).The similar results were observed among the intestinal-type GC cases.Conclusion Abnormal expression of CDX2 plays an important role in the development of IM and GC,especially in intestinal-type GC.GCs with high CDX2 index have low invasion,high differentiation and fewer lymph node metastasis.Detection of CDX2 expression in gastric cancer tissues can be useful in the determination of malignancy and prognosis.