Xu Yang, Wu Yue, Liu Jianhong, Xiao Lili, Zhang Ying
Department of Gastroenterology, Daqing Oilfield General Hospital, Daqing, Heilongjiang, 163000, People's Republic of China.
Department of Breast and Thyroid Surgery, Daqing Oilfield General Hospital, Daqing, Heilongjiang, 163000, People's Republic of China.
Int J Gen Med. 2024 Sep 27;17:4377-4394. doi: 10.2147/IJGM.S471727. eCollection 2024.
The study explored the prognostic value of caudal-type homeobox transcription factor 2 (CDX2) in stage II and III gastric cancer.
This study evaluated the expression level of CDX2 in gastric cancer in a hospital cohort (n=197) using immunohistochemistry. According to a semiquantitative score used to determine CDX2 expression, the cases were divided into a low CDX2 group (116 cases) and a high CDX2 group (81 cases). The RNA-seq expression data from 291 patients with stage II and III gastric cancer from The Cancer Genome Atlas (TCGA) cohort were used to verify the immunohistochemistry results. Based on the median CDX2 expression value, the TCGA patients were divided into a low CDX2 group (145 cases) and a high CDX2 group (146 cases). The relationships among CDX2 expression and clinicopathological features were determined using the Chi-square test. Cox proportional hazards regression models were applied to estimate the independent prognostic factors. The probability of survival was determined using the Kaplan-Meier method and Log rank tests.
Based on the Cox multivariate analysis, CDX2 was the independent prognostic factor in the hospital and TCGA cohorts. In the hospital cohort, CDX2 expression was associated with an improved DFS (hazard ratio [HR] = 0.4076, 95% CI, 0.2675-0.6210, = 0.0001) and OS (HR = 0.4183, 95% CI, 0.2744-0.6375, = 0.0002). In the TCGA cohort, CDX2 expression also was associated with an improved DFS (HR = 0.5948, 95% CI, 0.4153-0.8521, = 0.0054) and OS (HR = 0.5976, 95% CI, 0.4172-0.8561, = 0.0058). Furthermore, the CDX2 expression level was correlated with an improved DFS ( = 0.0025) and OS ( = 0.0015) using the Kaplan-Meier Plotter database for gastric cancer.
CDX2 is a potential prognostic biomarker for stage II and III gastric cancer. In addition, CDX2 positive cancer patients are more likely to have resectable tumors and exhibit better survival rates.
本研究探讨了尾型同源盒转录因子2（CDX2）在II期和III期胃癌中的预后价值。
本研究采用免疫组织化学方法评估了一家医院队列（n = 197）中胃癌组织中CDX2的表达水平。根据用于确定CDX2表达的半定量评分，将病例分为低CDX2组（116例）和高CDX2组（81例）。来自癌症基因组图谱（TCGA）队列的291例II期和III期胃癌患者的RNA测序表达数据用于验证免疫组织化学结果。根据CDX2表达的中位数，将TCGA患者分为低CDX2组（145例）和高CDX2组（146例）。采用卡方检验确定CDX2表达与临床病理特征之间的关系。应用Cox比例风险回归模型估计独立预后因素。采用Kaplan-Meier法和Log秩检验确定生存概率。
基于Cox多变量分析，CDX2是医院队列和TCGA队列中的独立预后因素。在医院队列中，CDX2表达与DFS改善相关（风险比[HR]=0.4076，95%CI，0.2675 - 0.6210，P = 0.0001）和OS改善相关（HR = 0.4183，95%CI，0.2744 - 0.6375，P = 0.0002）。在TCGA队列中，CDX2表达也与DFS改善相关（HR = 0.5948，95%CI，0.4153 - 0.8521，P = 0.0054）和OS改善相关（HR = 0.5976，95%CI，0.4172 - 0.8561，P = 0.0058）。此外，使用胃癌的Kaplan-Meier Plotter数据库，CDX2表达水平与DFS改善（P = 0.0025）和OS改善（P = 0.0015）相关。
CDX2是II期和III期胃癌的潜在预后生物标志物。此外，CDX2阳性的癌症患者更有可能有可切除的肿瘤，并且生存率更高。
