Expression and significance of Cdx2 in digestive and urogenital system tumors / 国际肿瘤学杂志

ABSTRACT

Cdx2 plays an important role in the proliferation and differentiation of normal intestinal cells. It has been suggested that Cdx2 is a master regulator of the intestinal differentiation program and is therefore not usually expressed outside the intestinal organs. Loss of Cdx2 expression leads to focal gastric differentiation in the colon, whereas aberrant expression of Cdx2 in the upper digestive tract may induce the initial trans-differentiation to intestinal metaplasia. The detection of a strong nuclear immunoreactivity for Cdx2 in metaplastic cells suggests that the protein is a major transcription factor in the development of intestinal metaplasia.Abnormal expression of Cdx2 is also correlated with early stage of adenocarcinoma in different organs, indicating that the protein may play an anti-oncogenic role in cancer development. The Inflammation-metaplasia-cancer'sequence is a frequent event in the lower esophagus, stomach, uterine cervix and the bladder. In all these specific anatomical sites, the noxious stimuli leading to metaplasia may have direct and/or indirect carcinogenic effects on chronically injured cells and Cdx2 plays a key role in the cascade process. Detection of Cdx2 expression in adenocarcinoma may be useful in the evaluation of malignancy and prognosis.