AIM:To investigate the expression and significance of caudal-related homeobox transcription factor(Cdx2) in gastric carcinoma(GC) and precancerous lesions.METHODS:The expression of Cdx2 in GC,precancerous lesions and normal gastric mucosa were detected using immunohistochemical method.Hematoxylin and eosin staining,alcian blue/periodic acid-schiff and high iron diamine/alcian blue staining were used to classify intestinal metaplasia(IM) and GC.RESULTS:Cdx2 was not detected in normal gastric mucosa.Cdx2 expression was detected in 87.1%(101/116) of IM,50%(36/72) of dysplasia and 48.2%(41/85) of GC.The Cdx2-expressing cells in IM were more prevalent than in dysplasia and carcinoma(P < 0.05).There was no relationship between Cdx2 expression and the classification of IM or the degree of dysplasia.Expression of Cdx2 was significantly higher in intestinal-type carcinoma than in diffuse and mixedtype carcinoma(P < 0.05).Positive expression of Cdx2was mainly found in moderately to well differentiated GC.There was a negative association between nuclear Cdx2 expression and lymph node metastasis and tumor,nodes,metastasis stage of GC(P < 0.05).The patients with Cdx2-positive expression showed a higher survival rate than those with Cdx2-negative expression(P = 0.038).Multivariate analysis revealed that the expression of Cdx2 and lymph node metastasis were independent prognostic indicators of GC(P < 0.05).CONCLUSION:Cdx2 may be closely related to IM and the intestinal-type GC and implicate better biological behavior and outcome.Cdx2 is useful for predicting the prognosis of GC.
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