CDX2 Is a Prognostic Biomarker for Unresectable Metastatic Colorectal Cancer

Junko Mukohyama; Kyosuke Agawa; Kimihiro Yamashita; Takeru Matsuda; Masahiro Shinoda; Osamu Itano; Yoshihiro Kakeji

doi:10.21873/anticanres.16561

CDX2 Is a Prognostic Biomarker for Unresectable Metastatic Colorectal Cancer

Anticancer Res. 2023 Aug;43(8):3763-3767. doi: 10.21873/anticanres.16561.

Authors

Junko Mukohyama^{1

2

3}, Kyosuke Agawa^{3

4}, Kimihiro Yamashita³, Takeru Matsuda³, Masahiro Shinoda⁵, Osamu Itano², Yoshihiro Kakeji³

Affiliations

¹ Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare MITA Hospital, Tokyo, Japan; jmukohyama@iuhw.ac.jp.
² Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare Narita Hospital, Narita, Japan.
³ Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
⁴ Department of surgery, Japan Organization of Occupational Health and Safety Kobe Rosai Hospital, Kobe, Japan.
⁵ Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare MITA Hospital, Tokyo, Japan.

PMID: 37500172
DOI: 10.21873/anticanres.16561

Abstract

Background/aim: Colorectal cancer (CRC) with reduced expression of the homeobox transcription factor CDX2, a master gene essential for the development and maintenance of the intestinal tract, is known as a poor prognosis subtype of CRC. The recurrence rate is high in patients with CDX2^low CRC. However, the prognostic significance of CDX2 in advanced CRC is unclear. This study aimed to elucidate the prognostic significance of CDX2 in unresectable metastatic CRC (mCRC).

Patients and methods: Twenty-nine patients with unresectable mCRC who underwent primary site resection at the Kobe University Hospital during a 6-year period from January 2008 to January 2015 were included. The tissues from those patients were immunohistochemically stained with anti-CDX2 antibody (clone: CDX2-88). The patients were divided into CDX2^high CRC group and CDX2^low CRC group and their prognoses were analyzed.

Results: There were no clear differences in background between the two groups. A low CDX2 expression was associated with reduced overall survival (37.67 months vs. 25.32 months, p=0.03) and tended to associate with reduced progression-free survival (17.4 months vs. 12.9 months, p=0.37). Two patients received chemotherapy after resection of the primary lesion and obtained pathological complete response.

Conclusion: CDX2 expression might be a possible prognostic biomarker for unresectable mCRC.

Keywords: CDX2; primary tumor resection; unresectable colon cancer.

MeSH terms

Biomarkers, Tumor / genetics
CDX2 Transcription Factor* / genetics
Colorectal Neoplasms* / diagnosis
Colorectal Neoplasms* / pathology
Humans
Prognosis

Substances

Biomarkers, Tumor
CDX2 Transcription Factor