CDX2 Expression in Gastric Carcinoma: A Clinicopathological Study

Abstract

Background: Gastric cancer accounts for 7.8% of cancers worldwide and adenocarcinoma is the commonest histological type. Both gastric and intestinal phenotypic cell markers are expressed in gastric carcinomas. CDX2 is an intestinal transcription factor, which can be demonstrated in intestinal metaplasia and gastric carcinomas of the intestinal type. Unlike colorectal carcinomas, the role of CDX2 in gastric carcinomas as a prognostic variable is yet to be established. Ki-67 is a transcription factor expressed in the growth and synthetic phases of the cell cycle. Aims and Objectives: The aims of the study were to analyze CDX2 expression and Ki-67 labeling index in different histological types of gastric carcinomas and their relationship with the patients' clinicopathological parameters. Materials and Methods: A total of 50 gastric carcinoma cases were evaluated histologically and phenotypically, along with assessment of CDX2 expression and Ki-67 labeling index. Gastric carcinomas were grouped into intestinal and diffuse types, according to Lauren classification. A semiquantitative microscopic evaluation of CDX2 expression and Ki-67 labeling index was performed and correlated with the patients' clinicopathological parameters. Results: Increased CDX2 expression correlated with higher proportion of intestinal type gastric carcinomas and a lower proportion of lymph node metastasis, lymphovascular and perineural invasion. On the other hand, high Ki-67 labeling index was found in high grade tumors with lymphovascular invasion. Conclusions: The results of our study suggest that CDX2 might be a useful marker in predicting the prognosis of patients with gastric carcinoma. Accordingly, Ki-67 index seems to be useful in identifying a group of patients with aggressive tumors.

CDX2 and Ki-67 Expression in Gastric Carcinoma and Its Association with Clinocopathological Parameters

“…These results collectively determine that CDX2 expression in GC might be a novel prognostic marker for patient survival. Despite the demonstration of inverse association between CDX2 and Ki-67 in our study, which is similar to other studies [19], [24], there was no significant association between CDX2 and Ki-67.…”

“…Majority of the cases expressed low Ki-67. A study conducted by Halder A et a l (2018) [19] reported high Ki67 was associatedwith depth of tumor invasion . Thus, a significant inverse association between Ki-67 expression and depth of tumor invasion was detected in the current study [20,21].…”

“…Thus, indicating an inverse relationship between these two markers. A study by Halder et al (2018) (19) reported CDX2 expression correlation with Ki 67 index. Strong CDX2 expression was related with low Ki 67 index and negative or low CDX2 expression was related with high Ki 67 index.…”

Predictive Value of CDX2 and SOX2 in Chronic Gastritis and Intestinal-type Gastric Cancer

“…However, Saha et al [24], in their study, found a median age of 55 years with male:female ratio of 2.7:1. In Halder et al [11] study, the mean age was 51.16 years with a male:female ratio of 1.63:1.…”

“…It regulates many cellular processes such as cell differentiation, proliferation, cell adhesion, migration, and tumor genesis [10]. Its role as a prognostic marker in colorectal carcinomas is well known, whereas its role in the outcome of gastric carcinomas is not yet established [11].…”