钙黏蛋白-17和尾型相关同源盒转录因子（CDX2）在人胃癌中表达的临床病理研究

A clinicopathological study on the expression of cadherin-17 and caudal-related homeobox transcription factor (CDX2) in human gastric carcinoma.

作者信息

Ge Jie, Chen Zhikang, Wu Shaobin, Yuan Weijie, Hu Bin, Chen Zihua

机构信息

Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.

出版信息

Clin Oncol (R Coll Radiol). 2008 May;20(4):275-83. doi: 10.1016/j.clon.2008.01.013. Epub 2008 Mar 19.

DOI:10.1016/j.clon.2008.01.013

PMID:18353622

Abstract

AIMS

To analyse the clinicopathological characteristics of the expression of cadherin-17 (CDH17) and caudal-related homeobox transcription factor (CDX2) in human gastric carcinoma, and to evaluate the clinical significance of these two markers in the histological classification and prognosis of gastric carcinoma.

MATERIALS AND METHODS

CDH17, CDX2 protein expression in paraffin-embedded specimens gathered from 166 patients with gastric carcinoma were detected by immunohistochemistry. The association of CDH17, CDX2 protein expression with the clinicopathological characteristics, and with the prognosis of gastric carcinoma were subsequently assessed.

RESULTS

CDH17, nucleus and cytoplasm CDX2 expression were positively expressed in 101/166 (60.8%), 59/166 (35.5%) and 57/166 (34.3%) gastric carcinoma patients, respectively. The expression of both CDH17 and CDX2 is associated with the intestinal-type gastric carcinoma (P<0.01). Positive expression of CDH17 was significantly associated with the depth of gastric wall invasion (P=0.04), lymph node metastasis (P<0.01) and stages of gastric carcinoma (P=0.01). Positive expression of CDX2 in the nucleus was mainly found in male patients (P=0.02), in early stage (P=0.01) and medullary-type gastric carcinoma (P=0.02). There was a negative association between nuclear CDX2 expression and lymph node metastasis of gastric carcinoma (P<0.01). The combined expression of CDH17 and CDX2 was significantly lower in diffuse-type carcinoma than intestinal- or mixed-type carcinoma (P<0.01 and P=0.01, respectively). The patients with CDH17 expression associated with poor prognosis of gastric carcinoma (P<0.01), as opposed to patients with CDX2 expression (P<0.01). The survival rate of patients with CDH17+/CDX2- expression was the lowest (P<0.01), and conjoined expressions of CDH17+/CDX2- and CDH17+/CDX2+ were independent prognostic indicators of gastric carcinoma (both P<0.01).

CONCLUSION

The results suggest that the expression of CDH17 or CDX2 may be an important feature of gastric carcinoma. A combined detection of CDH17/CDX2 co-expression may benefit us in predicting the prognosis of gastric carcinoma.

摘要

目的

分析钙黏蛋白-17（CDH17）和尾型相关同源盒转录因子（CDX2）在人胃癌中的表达及其临床病理特征，评估这两种标志物在胃癌组织学分类及预后中的临床意义。

材料与方法

采用免疫组织化学法检测166例胃癌石蜡包埋标本中CDH17、CDX2蛋白的表达。随后评估CDH17、CDX2蛋白表达与临床病理特征及胃癌预后的相关性。

结果

166例胃癌患者中，CDH17、核及胞质CDX2表达阳性率分别为101/166（60.8%）、59/166（35.5%）和57/166（34.3%）。CDH17和CDX2的表达均与肠型胃癌相关（P<0.01）。CDH17阳性表达与胃癌壁浸润深度（P=0.04）、淋巴结转移（P<0.01）及胃癌分期（P=0.01）显著相关。核CDX2阳性表达主要见于男性患者（P=0.02）、早期（P=0.01）及髓样型胃癌（P=0.02）。核CDX2表达与胃癌淋巴结转移呈负相关（P<0.01）。CDH17和CDX2的联合表达在弥漫型癌中显著低于肠型或混合型癌（分别为P<0.01和P=0.01）。CDH17表达与胃癌预后不良相关（P<0.01），而CDX2表达则相反（P<0.01）。CDH17+/CDX2-表达患者的生存率最低（P<0.01），CDH17+/CDX2-和CDH17+/CDX2+的联合表达是胃癌独立的预后指标（均为P<0.01）。