Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer

Andreea-Corina Ilie-Petrov; Daniel-Alin Cristian; Florin Andrei Grama; Andrei Chitul; Angela Blajin; Andrei Popa; Draga-Maria Mandi; Luminița Welt; Marina Alina Bara; Rareș Vrîncianu; Carmen Maria Ardeleanu

doi:10.3390/diagnostics14101023

journal article Open Access May 15, 2024

Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer

Andreea-Corina Ilie-Petrov

Daniel-Alin Cristian Florin Andrei Grama Andrei Chitul Angela Blajin Andrei Popa Draga-Maria Mandi

Luminița Welt Marina Alina Bara Rareș Vrîncianu Carmen Maria Ardeleanu

Diagnostics Vol. 14 No. 10 pp. 1023 · MDPI AG

View at Publisher Save 10.3390/diagnostics14101023

Abstract

Encoded by the CDX2 homeobox gene, the CDX2 protein assumes the role of a pivotal transcription factor localized within the nucleus of intestinal epithelial cells, orchestrating the delicate equilibrium of intestinal physiology while intricately guiding the precise development and differentiation of epithelial tissue. Emerging research has unveiled that positive immunohistochemical expression of this protein shows that the CDX2 gene exerts a potent suppressive impact on tumor advancement in colorectal cancer, impeding the proliferation and distant dissemination of tumor cells, while the inhibition or suppression of CDX2 frequently correlates with aggressive behavior in colorectal cancer. In this study, we conducted an immunohistochemical assessment of CDX2 expression on a cohort of 43 intraoperatively obtained tumor specimens from patients diagnosed with colon cancer at Colțea Clinical Hospital in Bucharest, between April 2019 and December 2023. Additionally, we shed light on the morphological diversity within colon tumors, uncovering varying differentiation grades within the same tumor, reflecting the variations in CDX2 expression as well as the genetic complexity underlying these tumors. Based on the findings, we developed an innovative immunohistochemical scoring system that addresses the heterogeneous nature of colon tumors. Comprehensive statistical analysis of CDX2 immunohistochemical expression unveiled significant correlations with known histopathological parameters such as tumor differentiation grades (p-value = 0.011) and tumor budding score (p-value = 0.002), providing intriguing insights into the complex involvement of the CDX2 gene in orchestrating tumor progression through modulation of differentiation processes, and highlighting its role in metastatic predisposition. The compelling correlation identified between CDX2 expression and conventional histopathological parameters emphasizes the prognostic significance of the CDX2 biomarker in colon cancer. Moreover, our novel immunohistochemical scoring system reveals a distinct subset of colon tumors exhibiting reserved prognostic outcomes, distinguished by their “mosaic” CDX2 expression pattern.

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Details

Published: May 15, 2024
Vol/Issue: 14(10)
Pages: 1023
License: View

Authors

A

Andreea-Corina Ilie-Petrov

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

D

Daniel-Alin Cristian

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

F

Florin Andrei Grama

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

A

Andrei Chitul

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

A

Angela Blajin

Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

A

Andrei Popa

Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

D

Draga-Maria Mandi

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Clinical General Surgery Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

L

Luminița Welt

Pathology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

M

Marina Alina Bara

Pathology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

R

Rareș Vrîncianu

Medical Oncology Department, Colțea Clinical Hospital, 030171 Bucharest, Romania

C

Carmen Maria Ardeleanu

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; Pathology Department, OncoTeam Diagnostic Laboratory, 010719 Bucharest, Romania

Cite This Article

Andreea-Corina Ilie-Petrov, Daniel-Alin Cristian, Florin Andrei Grama, et al. (2024). Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer. Diagnostics, 14(10), 1023. https://doi.org/10.3390/diagnostics14101023

Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer

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