Relation between CDX2 and survival in patients with gastric cancer

Abstract

In northwest of Iran, gastric cancer is the first and third common form of malignancy in men and women respectively. Homeobox protein CDX2, was proposedas a prognostic biomarker in gastric cancer. This study aimed to assess the association of CDX2 expression overall survival (OS) as well as clinicopathologic variables in patients with gastric cancer. CDX2 expression was examined by the immunohistochemistry method in the formalin-fixed paraffin-embedded surgical specimens of gastric cancer. The association between CDX2 expression and OS, stage of the disease, metastasis status, pathology type of the tumor, and serum levels of tumor markers CEA, CA-125 and CA19-9 was then evaluated. Ninety-two patients with primary gastric cancer were recruited. CDX2 expression was positive in 72 (78%) of the subjects. OS was not significantly different between two groups of patients (CDX2 positive vs. negative). However, the risk of death was 21% lower in CDX2 positive patients, after adjusting for age and gender ( P = .565). Disease stage and metastasis rate were significantly lower in CDX2 positive patients ( P = .027, and P = .021 respectively) and 71% of the CDX2 positive subjects had intestinal pathology type of the disease ( P = .025). Significant lower levels of CA19-9 were found in CDX2 positive patients as well ( P = .002). There was not any significant association between CDX2 expression and OS in patients with gastric cancer, although the risk of death was lower in CDX2 positive subjects. However, there was a less invasive pattern of gastric carcinoma in this group of patients.