, Volume 453, Issue 5, pp 521-527
Date: 09 Oct 2008

Aberrant expression of an “intestinal marker” Cdx2 in pyloric gland adenoma of the gallbladder

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Abstract

The aim of this study was to survey Cdx2 expression in pyloric gland adenoma (PGA) of the gallbladder. We reviewed 29 PGA cases, ten (34.4%) and seven (24.1%) of which showed intestinal metaplasia (IM) and squamous morule (SM), respectively. The immunostaining for Cdx2, beta-catenin, MUC5AC, MUC2, MUC6, and M-GGMC-1 was performed and scored (0 = negative, 1+ = <10%, 2+ = 10% to <30%, 3+ = 30% to <50%, 4+ = 50% to <70%, 5+ = 70–100%). Although its scores were relatively low (1+ or 2+), Cdx2 was frequently expressed in 27 cases (93.1%). Not only goblet and/or Paneth cells were positive but also non-IM cells in PGAs, as opposed to the lack of staining in the background mucosa. Cdx2 scores were not correlated with those of IM (p = 0.485) and MUC2 (p = 0.868). Of note, Cdx2 was positive in foci of SM in all seven cases, and there was a significant difference in Cdx2 scores between PGAs with and without SM. Furthermore, the p value of scores between Cdx2 and beta-catenin was 0.051, and both mean labeling indices (LIs) were correlated (r = 0.736). With Cdx2, higher morular LIs than glandular LIs were observed (p = 0.001). Finally, we concluded that aberrant Cdx2 expression in PGAs is closely associated with nuclear beta-catenin expression and SM in contrast with IM.