Immunohistochemical Expression Of CDX-2 In Gastric Adenocarcinoma And Its Clinico Pathological Correlation

Abstract

Introduction: The fifth most frequent cause of cancer-related mortalities globally is gastric cancer. Histologically, adenocarcinoma is the most prevalent form. CDX-2, a transcription factor associated with the caudal related homeobox, is typically found in intestinal metaplasia and gastric cancer (intestinal type). Role of CDX-2 in gastric carcinoma as prognostic variable is not well established.
Aim: The aim of the present study was to analyse CDX-2 expression in different histological types of gastric adenocarcinomas and its relationship with the patients’ clinicopathological parameters.
Materials and Methodology: A cross-sectional study was performed using paraffin blocks of gastric adenocarcinoma reported between 2017 and 2024. For light microscopy screening, sections were initially stained with haematoxylin and eosin (H&E) stains. In further sections, primary antibody against CDX-2 was applied. The CDX-2 expression level in gastric adenocarcinoma was evaluated using a scoring system.
Results: Fifty cases with gastric adenocarcinoma were included. Among which only histological type (p-0.027) and histological grade (p-0.000) were statistically significant. Increased CDX-2 expression correlated with higher proportion of intestinal type gastric carcinomas while decreased CDX-2 expression correlated with higher histological grade of tumour.
Conclusion: In conclusion, CDX-2 is a crucial marker for the intestinal type of gastric adenocarcinoma. CDX-2 expression showed statistical significance only with the histological type and grade of the tumour. Although not statistically significant, lower levels of CDX-2 positivity were associated with greater depth of invasion and a higher rate of lymph node metastasis, suggesting that CDX-2 immunoexpression may serve as a significant prognostic marker in gastric adenocarcinoma.