CDX2 as a prognostic marker in gastric cancer

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.

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

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.

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).

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