Caudal-related homeobox transcription factor (CDX-2) is selectively localized in the fetal and adult mu-cosal epithelial nuclei of normal small and large intestines.CDX2 plays an important role in the regulation of cell proliferation and differentiation of the intestinal epithelium. Ec-topic expression of CDX-2 in the stomach, esophagus and other hollow organs might be a cause of intestinal metaplasia and adenocarcinoma. CDX-2 is expressed in both cultured and primary gallbladder carcinoma cells, and dysplasia.CDX2 is not detected in normal gallbladder and biliary tract mucosa. Ectopic CDX2 expression is an early event in gallbladder carcinogenesis. The frequency of CDX-2 expression is significantly higher in well-differentiated type than in the moderately and poorly differentiated tumors. The present study clearly showed that MUC2 expression in intestinal differentiation was dependent on the nuclear expression of CDX-2 in intraductal papillary neoplasia of the liver (IPNL)and mucinous intrahepatic cholangiocarcinoma (ICC) in the same manner as in the gastric mucosa and Barrett s esophagus. CDX-2 may also be a key factor in gallbladder carcinogenesis with intestinal differentiation and is a useful immuno-histochemical marker of intestinal differentiation in intestinal metaplasia of the gallbladder. CDX2-dependent regulation of cell proliferation may be an important factor in defining prognosis of patients with BTC.%尾相关同源盒转录因子2(CDX-2)在肠上皮细胞正常分化中起着关键作用.如果CDX-2在肠道黏膜中表达缺失、突变或存肠道以外的空腔脏器中异位表达时则促进了该部位肠化生和癌的发生.正常情况下,CDX-2在胆囊和胆道黏膜中均无表达.在慢性胆囊炎、胆囊结石、发育不良的胆囊黏膜上皮细胞和胆囊癌中表达.越邻近肠道的胆道肿瘤CDX-2表达的阳性率越高.CDX-2在胆囊黏膜中通过促进肠化生再导致癌变的过程与其在胃黏膜中的作用相类似.CDX-2在胆道肿瘤发生的早期起着重要作用,并且是决定胆道恶件肿瘤患者预后的一项重要因素.
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