Gastric Cancer
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2005; 11(21): 3182-3188
Published online Jun 7, 2005. doi: 10.3748/wjg.v11.i21.3182
Co-expression of CDX2 and MUC2 in gastric carcinomas: Correlations with clinico-pathological parameters and prognosis
Kristina Roessler, Stefan P. Mönig, Paul M. Schneider, Franz-Georg Hanisch, Stephanie Landsberg, Juergen Thiele, Arnulf H. Hölscher, Hans P. Dienes, Stephan E. Baldus
Kristina Roessler, Stephanie Landsberg, Juergen Thiele, Hans P. Dienes, Stephan E. Baldus, Institute of Pathology, University of Cologne, 50931 Cologne, Germany
Stefan P. Mönig, Paul M. Schneider, Arnulf H. Hölscher, Department of Visceral and Vascular Surgery, University of Cologne, 50931 Cologne, Germany
Franz-Georg Hanisch, Center of Biochemistry, University of Cologne, Cologne, Germany
Author contributions: All authors contributed equally to the work.
Supported by the Cologne Fortune Program
Correspondence to: Dr. Stephan E. Baldus, Institute of Pathology, University of Cologne, Joseph-Stelzmann-Str. 9, D-50931 Cologne, Germany. s-e.baldus@uni-koeln.de
Telephone: +49-221-478-6372 Fax: +49-221-478-6360
Received: August 30, 2004
Revised: August 31, 2004
Accepted: October 7, 2004
Published online: June 7, 2005
Abstract

AIM: To evaluate the role of CDX2 homeobox protein as a predictor for cancer progression and prognosis as well as its correlation with MUC2 expression. CDX2 represents a transcription factor for various intestinal genes (including MUC2) and thus an important regulator of intestinal differentiation, which could previously be identified in gastric carcinomas and intestinal metaplasia.

METHODS: Formalin-fixed and paraffin-embedded tissues from 190 gastric carcinoma patients were stained with monoclonal antibodies recognizing CDX2 and MUC2, respectively. Immunoreactivity was evaluated semiquantitatively and statistical analyses including χ2 tests, uni- and multi-variate survival analyses were performed.

RESULTS: CDX2 was mostly expressed in a nuclear or supranuclear pattern, whereas MUC2 showed an almost exclusive supranuclear reactivity. Both antigens were present in >80% of areas exhibiting intestinal metaplasia. An immunoreactivity in >5% of the tumor area was observed in 57% (CDX2) or in 21% (MUC2) of the carcinomas. The presence of both molecules did not correlate with WHO, Laurén and Goseki classification (with the exception of a significantly stronger MUC2 expression in mucinous tumors). CDX2 correlated with a lower pT and pN stage in the subgroups of intestinal and stage I cancers and was associated with MUC2 positivity. A prognostic impact of CDX2 or MUC2 was not observed.

CONCLUSION: CDX2 and MUC2 play an important role in the differentiation of normal, inflamed, and neoplastic gastric tissues. According to our results, loss of CDX2 may represent a marker of tumor progression in early gastric cancer and carcinomas with an intestinal phenotype.

Keywords: CDX2; MUC2; Monoclonal antibody; Gastric carcinoma; Prognosis