Immunohistochemical expression of CDX2 gene in colorectal carcinoma
Background and objective: Colorectal cancer is a multi-factorial disease process, with etiology encompassing genetic factors, environmental exposures, and inflammatory conditions of the digestive tract. This study aimed to investigate the immunohistochemical expression of CDX2 as well as clinical and histopathological parameters of patients with colorectal cancer in Erbil, Kurdistan.
Methods: A retrospective study including about 100 colorectal cancer cases in Erbil city, Kurdistan was conducted from January 2015 to January 2017. Tumor type, site, size, histological grade, lymph node status, and pathological stage with CDX2 expression were investigated.
Results: CDX2 was expressed in 86 out of 100 (86%) patients. It was more expressed (focal or diffuse staining) in nonmucinous carcinoma more than signet ring and mucinous carcinoma. Loss of CDX2 expression in colorectal cancer is associated with a high tumor grade and stage. Significant associations between CDX2 expression with both tumor type and tumor grade were observed. Although CDX2 expression was found to be reduced in proximal location (right colon) and higher stage, however, no significant associations between CDX2 expressions in colorectal cancer were detected with tumor site, nodal status, and tumor stage.
Conclusion: Reduced and loss CDX2 expression in colorectal cancer associated with high tumor grades as well as with the mucinous and signet ring cell carcinomas may reflect aggressive tumor behavior probably because of the CDX2 tumor-inhibitory properties. However, the full extent of CDX2’s antitumor effects has yet to be elucidated.
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