Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare MITA Hospital, Tokyo, Japan;
Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
Anticancer Res. 2023 Aug;43(8):3763-3767. doi: 10.21873/anticanres.16561.
BACKGROUND/AIM: Colorectal cancer (CRC) with reduced expression of the homeobox transcription factor CDX2, a master gene essential for the development and maintenance of the intestinal tract, is known as a poor prognosis subtype of CRC. The recurrence rate is high in patients with CDX2 CRC. However, the prognostic significance of CDX2 in advanced CRC is unclear. This study aimed to elucidate the prognostic significance of CDX2 in unresectable metastatic CRC (mCRC).
Twenty-nine patients with unresectable mCRC who underwent primary site resection at the Kobe University Hospital during a 6-year period from January 2008 to January 2015 were included. The tissues from those patients were immunohistochemically stained with anti-CDX2 antibody (clone: CDX2-88). The patients were divided into CDX2 CRC group and CDX2 CRC group and their prognoses were analyzed.
There were no clear differences in background between the two groups. A low CDX2 expression was associated with reduced overall survival (37.67 months vs. 25.32 months, p=0.03) and tended to associate with reduced progression-free survival (17.4 months vs. 12.9 months, p=0.37). Two patients received chemotherapy after resection of the primary lesion and obtained pathological complete response.
CDX2 expression might be a possible prognostic biomarker for unresectable mCRC.
背景/目的：结直肠癌（CRC）中存在同源盒转录因子 CDX2 表达降低的情况，CDX2 是肠道发育和维持所必需的主基因，其被认为是 CRC 的预后不良亚型。CDX2 CRC 患者的复发率较高。然而，CDX2 在晚期 CRC 中的预后意义尚不清楚。本研究旨在阐明 CDX2 在不可切除转移性 CRC（mCRC）中的预后意义。
纳入了 2008 年 1 月至 2015 年 1 月期间在神户大学医院接受原发性肿瘤切除的 29 例不可切除 mCRC 患者。使用抗 CDX2 抗体（克隆：CDX2-88）对这些患者的组织进行免疫组织化学染色。将患者分为 CDX2 CRC 组和 CDX2 CRC 组，并分析其预后。
两组患者的背景无明显差异。低 CDX2 表达与总生存期缩短相关（37.67 个月比 25.32 个月，p=0.03），且与无进展生存期缩短趋势相关（17.4 个月比 12.9 个月，p=0.37）。两名患者在切除原发性肿瘤后接受化疗并获得病理完全缓解。
CDX2 表达可能是不可切除 mCRC 的一种潜在预后生物标志物。
