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CDX2 Protein Expression in Colorectal Cancer and ItsCorrelation with Clinical and Pathological Characteristics, Prognosis, and Survival Rate of Patients

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Abstract

Purpose

Caudal-type homeobox transcription factor 2 (CDX2) is expressed in the nucleus of the intestinal epithelial cells and is essential for embryonic formation and differentiation of the intestine, whose reduced expression can result in metastatic tumors. This study was to investigate the association of CDX2 expression level in colorectal cancer (CRC) with age, gender, microscopic histopathology, tumor staging, tumor grading, 3-year survival rate, and prognosis.

Methods

After preparing paraffin tissue blocks, CDX2 protein expression was assayed by immunohistochemistry in 82 CRC patients. Hematoxylin and eosin staining was used to detect tumor histology, tumor grading, tumor staging, and blood-lymphatic, and neural invasion. The collected data includes age, gender, tumor site, and 3-year survival rate of patients after diagnosis.

Results

The CDX2 expression was significantly higher in men than in women, and it was significantly lower in right-sided tumors as in transverse colon and left-sided tumors. Also, the CDX2 expression was significantly higher in adenocarcinoma than in mucinous. In addition, a significant correlation was found between downregulated CDX2 and lymph node involvement. In tumor grading, there was a significant correlation between CDX2 downregulation and high-grade tumor. Moreover, there was a significant correlation between downregulated CDX2 expression and overall pathological staging.

Conclusion

The downregulated CDX2 expression is associated with female gender, right-sided tumors, mucinous tumors, lymph node involvement, high-grade tumor, and advanced overall pathological staging and can be considered as a possible prognostic factor for patients follow-up. However, our study is a preliminary study and further studies with larger sample sizes in different ethnic groups are required.

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Acknowledgments

The authors sincerely express their appreciation to the Vice Chancellor for Research and Technology, Kashan University of Medical Sciences, Kashan, Iran.

Availability of Data and Materials

The dataset used in the current project is available with the authors and can be made available upon request.

Funding

The financial support for the current research was provided by Research Deputy of Kashan University of Medical Sciences, Kashan, Iran (grant numbers: 96144).

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Authors and Affiliations

  1. Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran

    Shafigheh Asgari-Karchekani, Mohammad Karimian, Tahereh Mazoochi, Maryam Akhavan Taheri & Tahereh Khamehchian

  2. Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran

    Mohammad Karimian & Tahereh Mazoochi

  3. Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

    Tahereh Khamehchian

Authors
  1. Shafigheh Asgari-Karchekani
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  2. Mohammad Karimian
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  3. Tahereh Mazoochi
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  4. Maryam Akhavan Taheri
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  5. Tahereh Khamehchian
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Contributions

TK and TM participated in the design of study. SAK and MK collected and documented the data and analyzed them. MK and SAK wrote the initial draft. All of the authors participated in draft revision and paper finalization.

Corresponding author

Correspondence to Tahereh Khamehchian.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

The informed consent form was obtained from the study subjects. This study was approved by the Ethics Committee of Kashan University of Medical Sciences (Code of Ethics: IR.KAUMS.MEDNT.REC.1396.75).

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Asgari-Karchekani, S., Karimian, M., Mazoochi, T. et al. CDX2 Protein Expression in Colorectal Cancer and ItsCorrelation with Clinical and Pathological Characteristics, Prognosis, and Survival Rate of Patients. J Gastrointest Canc 51, 844–849 (2020). https://doi.org/10.1007/s12029-019-00314-w

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  • DOI: https://doi.org/10.1007/s12029-019-00314-w

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