CDX2 as a prognostic marker in gastric cancer.

BACKGROUND: There is considerable evidence in the literature to suggest a role for CDX2 in intestinal metaplasia and development of gastric cancer, but its impact on the prognosis of gastric cancer continues to be a matter of debate.

OBJECTIVE: We conducted this study to assess the prognostic -implications of CDX2 in gastric cancer.

METHOD: We retrospectively reviewed our database for gastric carcinoma cases diagnosed at our hospital from 2004 to 2008. Histopathology slides of these were subsequently stained with CDX2 immuno-histochemical stain. CDX2 positive and negative groups were then compared for overall survival.

RESULTS: A total of 101 patients (mean age 50y ; 60% male) were included in the study. 31/101 (30.7%) cases were CDX2 positive. Of these, 23/31 (74%) patients underwent curative surgical resection. In the CDX2 negative group, only 12/70 (17%) patients underwent curative surgery (p = .0001). Of those who underwent surgical resection, 9% had stage I, 37% had stage II, 43% had stage III, and 11% had stage IV tumours on TNM staging of post-surgical histological specimens. Mean overall survival of CDX2 positive group was 17 months, compared to 6 months in the CDX2 negative group (p = 0.0001).

CONCLUSIONS: CDX2 positive gastric carcinomas are more likely to be resectable and patients whose tumours stain positive for CDX2 have significantly better survival.