Expression of Cdx-2 Homeobox Gene in Intestinal Metaplasia and Gastric Adenocarcinoma.
- Author:
Chang Hee PAIK
1
;
Dong Soo HAN
;
Seung Hyun LEE
;
Yong Woo CHUNG
;
Jong Pyo KIM
;
Joo Hyun SOHN
;
Joon Soo HAHM
;
Young Ha OH
;
Yong Uk PARK
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea. hands@hanyang.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Cdx-2;
Intestinal metaplasia;
Gastric adenocarcinoma
- MeSH:
Adenocarcinoma/*genetics/metabolism;
Adult;
Aged;
English Abstract;
Female;
Gastric Mucosa/metabolism;
Gene Expression;
Genes, Homeobox/*genetics;
Homeodomain Proteins/*genetics/metabolism;
Humans;
Intestines/*pathology;
Male;
Metaplasia;
Middle Aged;
Stomach Neoplasms/*genetics/metabolism
- From:The Korean Journal of Gastroenterology
2004;44(4):186-192
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The Cdx-1 and Cdx-2 genes are intestinal transcription factors that may be involved in the regulation of proliferation and differentiation of intestinal epithelial cells. The Cdx-1 and Cdx-2 are expressed in the epithelium of the small intestine and colon but not in the normal epithelium of the esophagus and stomach. Conversely, aberrant Cdx-2 expression is often observed in the esophagus and stomach. We investigated the expression and role of Cdx-2 in intestinal metaplasia and gastric adenocarcinoma. METHODS: The gastric tissues obtained endoscopically were analyzed by the reverse transcriptase-polymerase chain reaction and histology. The Cdx-1 and Cdx-2 mRNA expression was confirmed and analyzed according to updated Sydney classification. Then, immunohistochemical study with monoclonal anti-Cdx-2 antibody was performed with gastric adenocarcinoma obtained by surgical resection. RESULTS: The prevalence of Cdx-1 and Cdx-2 mRNA expression was significantly higher in mucosa with intestinal metaplasia than mucosa without intestinal metaplasia. In immunohistochemical study, nuclear staining of Cdx-2 was strong in metaplastic mucosa, but weak in adjacent normal gastric mucosa (p<0.001). The expression of Cdx-2 in gastric adenocarcinoma was lower than in metaplastic mucosa (p<0.001). The Cdx-2 expression was also detected in 97% of intestinal type gastric adenocarcinoma and 61.5% of diffuse type gastric adenocarcinoma (p=0.003). CONCLUSIONS: Aberrant expression of Cdx-2 is observed in intestinal metaplasia and a subset of gastric adenocarcinoma, which is predominant in intestinal-type gastric adenocarcinoma. Therefore, Cdx-2 may play an important role in gastric carcinogenesis, especially in intestinal type adenocarcinoma.
