A clinicopathological study on the expression of cadherin-17 and caudal-related homeobox transcription factor (CDX2) in human gastric carcinoma

Aims: To analyse the clinicopathological characteristics of the expression of cadherin-17 (CDH17) and caudal-related homeobox transcription factor (CDX2) in human gastric carcinoma, and to evaluate the clinical significance of these two markers in the histological classification and prognosis of gastric carcinoma. Materials and methods: CDH17, CDX2 protein expression in paraffin-embedded specimens gathered from 166 patients with gastric carcinoma were detected by immunohistochemistry. The association of CDH17, CDX2 protein expression with the clinicopathological characteristics, and with the prognosis of gastric carcinoma were subsequently assessed. Results: CDH17, nucleus and cytoplasm CDX2 expression were positively expressed in 101/166 (60.8%), 59/166 (35.5%) and 57/166 (34.3%) gastric carcinoma patients, respectively. The expression of both CDH17 and CDX2 is associated with the intestinal-type gastric carcinoma (P < 0.01). Positive expression of CDH17 was significantly associated with the depth of gastric wall invasion (P = 0.04), lymph node metastasis (P < 0.01) and stages of gastric carcinoma (P = 0.01). Positive expression of CDX2 in the nucleus was mainly found in male patients (P = 0.02), in early stage (P:= 0.01) and medullary-type gastric carcinoma (P = 0.02). There was a negative association between nuclear CDX2 expression and lymph node metastasis of gastric carcinoma (P < 0.01). The combined expression of CDH17 and CDX2 was significantly lower in diffuse-type carcinoma than intestinal- or mixed-type carcinoma (P < 0.01 and P = 0.01, respectively). The patients with CDH 17 expression associated with poor prognosis of gastric carcinoma (P < 0.01), as opposed to patients with CDX2 expression (P < 0.01). The survival rate of patients with CDH17+/CDX2- expression was the lowest (P < 0.01), and conjoined expressions of CDH17+/CDX2- and CDH17+/CDX2+ were independent prognostic indicators of gastric carcinoma (both P < 0.01). Conclusion: The results suggest that the expression of CDH17 or CDX2 may be an important feature of gastric carcinoma. A combined detection of CDH17/CDX2 co-expression may benefit us in predicting the prognosis of gastric carcinoma.