AIM: To evaluate the role of CDX2 homeobox protein as a predictor for cancer progression and prognosis as well as its correlation with MUC2 expression. CDX2 represents a transcription factor for various intestinal gen...AIM: To evaluate the role of CDX2 homeobox protein as a predictor for cancer progression and prognosis as well as its correlation with MUC2 expression. CDX2 represents a transcription factor for various intestinal genes (including MUC2) and thus an important regulator of intestinal differentiation, which could previously be identified in gastric carcinomas and intestinal metaplasia. METHODS: Formalin-fixed and paraffin-embedded tissues from 190 gastric carcinoma patients were stained with monodonal antibodies recognizing CDX2 and MUC2, respectively. Immunoreactivity was evaluated semiquantitatively and statistical analyses including x2 tests, uni- and multi-variate survival analyses were performed. RESULTS: CDX2 was mostly expressed in a nuclear or supranuclear pattern,whereas MUC2 showed an almost exclusive supranuclear reactivity.Both antigens were present in >80% of areas exhibiting intestinal metaplasia. An immunoreactivity in >5% of the tumor area was observed in 57% (CDX2) or in 21% (MUC2) of the carcinomas.The presence of both molecules did not correlate with WHO, Lauren and Goseki classification (with the exception of a significantly stronger MUC2 expression in mucinous tumors). CDX2 correlated with a lower pT and pN stage in the subgroups of intestinal and stage I cancers and was associated with MUC2 positivity.A prognostic impact of CDX2 or MUC2 was not observed. CONCLUSION: CDX2 and MUC2 play an important role in the differentiation of normal, inflamed, and neoplastic gastric tissues. According to our results, loss of CDX2 may represent a marker of tumor progression in early gastric cancer and carcinomas with an intestinal phenotype.展开更多
Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer(CRC)characterized by the pres-ence of abundant extracellular mucin which accounts for at least 50%of the tumor volume.Mucinous colorectal a...Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer(CRC)characterized by the pres-ence of abundant extracellular mucin which accounts for at least 50%of the tumor volume.Mucinous colorectal adenocarcinoma is found in 10%-20%of CRC patients and occurs more commonly in female and younger patients.Moreover,mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage.Based on its molecular context,mucinous colorectal adenocarcinoma is associated with the over-expression of mucin 2(MUC2)and mucin 5AC(MUC5AC)proteins.At the same time,it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways.Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability(MSI)than non-mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype.The prognosis of mucinous colorectal adenocarcinoma as to non-mucinous colorectal adenocarcinoma is debatable.Further,the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients.In this review,we discuss the molecular background and histopathol-ogy of mucinous colorectal adenocarcinoma,and provide an update on its prognosis and therapeutics from recent literatures.展开更多
文摘AIM: To evaluate the role of CDX2 homeobox protein as a predictor for cancer progression and prognosis as well as its correlation with MUC2 expression. CDX2 represents a transcription factor for various intestinal genes (including MUC2) and thus an important regulator of intestinal differentiation, which could previously be identified in gastric carcinomas and intestinal metaplasia. METHODS: Formalin-fixed and paraffin-embedded tissues from 190 gastric carcinoma patients were stained with monodonal antibodies recognizing CDX2 and MUC2, respectively. Immunoreactivity was evaluated semiquantitatively and statistical analyses including x2 tests, uni- and multi-variate survival analyses were performed. RESULTS: CDX2 was mostly expressed in a nuclear or supranuclear pattern,whereas MUC2 showed an almost exclusive supranuclear reactivity.Both antigens were present in >80% of areas exhibiting intestinal metaplasia. An immunoreactivity in >5% of the tumor area was observed in 57% (CDX2) or in 21% (MUC2) of the carcinomas.The presence of both molecules did not correlate with WHO, Lauren and Goseki classification (with the exception of a significantly stronger MUC2 expression in mucinous tumors). CDX2 correlated with a lower pT and pN stage in the subgroups of intestinal and stage I cancers and was associated with MUC2 positivity.A prognostic impact of CDX2 or MUC2 was not observed. CONCLUSION: CDX2 and MUC2 play an important role in the differentiation of normal, inflamed, and neoplastic gastric tissues. According to our results, loss of CDX2 may represent a marker of tumor progression in early gastric cancer and carcinomas with an intestinal phenotype.
基金This work was supported by the Natural Science Foundation of Zhejiang Province(Grant No.LY15H160003),which supported the research infrastructure.
文摘Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer(CRC)characterized by the pres-ence of abundant extracellular mucin which accounts for at least 50%of the tumor volume.Mucinous colorectal adenocarcinoma is found in 10%-20%of CRC patients and occurs more commonly in female and younger patients.Moreover,mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage.Based on its molecular context,mucinous colorectal adenocarcinoma is associated with the over-expression of mucin 2(MUC2)and mucin 5AC(MUC5AC)proteins.At the same time,it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways.Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability(MSI)than non-mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype.The prognosis of mucinous colorectal adenocarcinoma as to non-mucinous colorectal adenocarcinoma is debatable.Further,the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients.In this review,we discuss the molecular background and histopathol-ogy of mucinous colorectal adenocarcinoma,and provide an update on its prognosis and therapeutics from recent literatures.
