Decreased CDX2 Expression Adversely Effect On Prognosis Of Patients With Colorectal Cancer

Authors : İlknur ÇALIK, Muhammet ÇALIK, İbrahim Hanifi ÖZERCAN, Adile Ferda DAĞLI, Gökhan ARTAŞ, Gülistan TÜRKEN, Burcu SARIKAYA

Pages : 57-65

Doi:10.5798/dicletip.706005

View : 30 | Download : 26

Publication Date : 2020-03-17

Article Type : Research Paper

Abstract :Objective: Since colorectal cancers (CRC) are tumors with heterogeneous biological behavior, prediction of their prognosis remains challenging. Caudal-related homeobox gene 2 (CDX2), which has important roles in the development and maintenance of intestines, is thought to have tumor suppressing effect on CRCs. The aim of this study was to investigate the prognostic significance of decreased-CDX2 expression. Method: This retrospective study included 224 patients diagnosed with CRC between 2009 and 2014. Paraffinized blocks of these patients were stained with CDX2 immunohistochemically and evaluated semiquantitatively. Results: Only 35 (15.6%) of 224 patients had low-CDX2 expression. Decrease in CDX2 expression was closely associated with classical prognostic parameters such as histopathologic type, histologic grade, lymph node metastasis, distant metastasis, and TNM stage. Patients with decreased-CDX2 expression had more lymph node metastasis (p=0.013) and advanced TNM stage (p=0.004) than those without decreased-expression. The mean survival was 53.0±0.89 months. Cox regression analysis showed that decreased-CDX2 expression was significantly related with overall survival (Univariate analysis; hazard ratio: 0.09, 95% confidence interval: 0.05-0.16; p<0.001; Multivariate analysis; hazard ratio: 0.24, 95% confidence interval: 0.13-0.48; p<0.001) and disease-free survival (Univariate analysis; hazard ratio: 0.80, 95% confidence interval: 0.05-0.13; p<0.001; Multivariate analysis; hazard ratio: 0.15, 95% confidence interval: 0.08-0.25; p<0.001). Conclusion: Decreased CDX2 expression is significantly related with worse biological features and can be used as an independent prognostic biomarker in patients with CRCs.
Keywords : Colorectal cancer, CDX2, prognosis, overall survival