Prognostic influence of CDX2 expression in gastric carcinoma after surgery with a curative intent.

INTRODUCTION AND OBJECTIVES: CDX2 is a specific transcription factor with a significant role in the early differentiation and maintenance of intestinal epithelial cells during gastrointestinal development and also as a tumor suppressor. The aim of this study was to assess the potential role of CDX2 expression as a prognostic predictor. MATERIAL AND METHODS: ninety-two of 206 (44.6%) patients with gastric carcinoma that underwent a curative surgery and had immunohistochemical staining for CDX2 were enrolled into the study; 51.1% were female and the average age was 74.07 years. Overall, 56.5% of tumors were of the intestinal type, 33.7% were diffuse and 9.8% were mixed; 23.9% were T1/T2, 76.1% were T3/T4 and lymph node metastases (N+) were identified in 69.6% of cases; 13% (12) were clinical stage I, 40.2% (37) were stage II and 46.7% (43) were stage III. RESULTS: a total of 68.5% (63) expressed CDX2. Our study suggests that CDX2 expression (HR = 0.339, p = 0.024) represents an independent risk marker together with the Lauren type (HR = 3.471, p = 0.022). There was association between a milder clinical stage and CDX2 expression (stage I) (p = 0.046). A significant difference was found in overall survival that favored patients with positive CDX2 expression (85.7% vs 65.5%, p = 0.012). CONCLUSION: our results confirm that CDX2 expression in gastric carcinoma is associated with improved prognosis, although further studies are needed to draw definitive conclusions.

Influencia pronóstica de la expresión de CDX2 en carcinoma gástrico operado con intención curativa / Prognostic influence of CDX2 expression in gastric carcinoma after surgery with a curative intent

Introducción y objetivo: el factor de transcripción de la homeocaja relacionada con caudal (CDX2) es un factor de transcripción específico que es importante en la diferenciación temprana, el mantenimiento de la célula epitelial intestinal durante el desarrollo gastrointestinal y como supresor tumoral. El objeto de este estudio es valorar el potencial papel de la expresión de CDX2 como predictor pronóstico. Material y métodos: de los 206 pacientes con carcinoma gástrico sometidos a cirugía con intención curativa, reclutamos a 92 (44,6%), a los que se les realizó tinción inmunohistoquímica con CDX2. El 51,1% son mujeres y la edad promedio fue de 74,07 años. El 56,5% son de tipo intestinal; el 33,7%, de tipo difuso; y el 9,8%, de tipo mixto. El 23,9% son T1/T2 y el 76,1%, T3/T4. Se identificaron metástasis ganglionares (N+) en el 69,6%. El 13% (12) son de estadio clínico I, el 40,2% (37) de II y el 46,7% (43) de III. Resultados: el 68,5% (63) expresó CDX2. Nuestro estudio indica que la expresión de CDX2 (HR 0,339, p = 0,024) representa un indicador de riesgo independiente, junto con el tipo de Lauren (HR 3,471, p = 0,022). Existe asociación entre un menor estadio clínico y la expresión de CDX2 (estadio I) (p = 0,046). Hay una diferencia significativa en términos de supervivencia global para los pacientes con expresión positiva de CDX2 (85,2% vs. 65,5%, p = 0,014). Conclusión: nuestros resultados confirman que la expresión de CDX2 en el carcinoma gástrico indica un mejor pronóstico. Se necesitan más estudios para poder obtener conclusiones definitivas

Introduction and objectives: CDX2 is a specific transcription factor with a significant role in the early differentiation and maintenance of intestinal epithelial cells during gastrointestinal development and also as a tumor suppressor. The aim of this study was to assess the potential role of CDX2 expression as a prognostic predictor. Material and methods: ninety-two of 206 (44.6%) patients with gastric carcinoma that underwent a curative surgery and had immunohistochemical staining for CDX2 were enrolled into the study; 51.1% were female and the average age was 74.07 years. Overall, 56.5% of tumors were of the intestinal type, 33.7% were diffuse and 9.8% were mixed; 23.9% were T1/T2, 76.1% were T3/T4 and lymph node metastases (N+) were identified in 69.6% of cases; 13% (12) were clinical stage I, 40.2% (37) were stage II and 46.7% (43) were stage III. Results: a total of 68.5% (63) expressed CDX2. Our study suggests that CDX2 expression (HR = 0.339, p = 0.024) represents an independent risk marker together with the Lauren type (HR = 3.471, p = 0.022). There was association between a milder clinical stage and CDX2 expression (stage I) (p = 0.046). A significant difference was found in overall survival that favored patients with positive CDX2 expression (85.7% vs 65.5%, p = 0.012). Conclusion: our results confirm that CDX2 expression in gastric carcinoma is associated with improved prognosis, although further studies are needed to draw definitive conclusions