肠型胃腺癌组织CDX2表达与临床表现和病理特征的关系OACSTPCD

Objective To analyze the relationship between immunohistochemical patterns of caudal type homeobex transcrip-tion factor 2(CDX2)in gastric cancer tissue of patients with intestinal adenocarcinoma and its clinical and pathological features.Methods Clinical data of 90 patients with intestinal gastric adenocarcinoma who underwent surgical resection in the 909th Hospital of PLA Joint Logistics Support Force from January 2022 to December 2022 were retrospectively collected.According to the immunohisto-chemical staining of CDX2,all patients were divided into CDX2 positive and CDX2 negative groups.The clinical manifestations,path-ological data,molecular characteristics of immunological and targeted therapy,and the relationship between CDX2 expression and sec-ond-generation gene sequencing results were compared between the two groups.Results According to immunohistochemical staining of CDX2 and CK7 in gastric cancer tissue,CDX2 positive/CK7 positive in 38 cases(42.22%)was the most common expression pattern,followed by CDX2 negative/CK7 positive in 30 cases(33.33%),CDX2 positive/CK7 negative in 16 cases(17.78%),and CDX2 negative/CK7 negative in 6 cases(6.67%).The maximum diameter of the tumor in the CDX2 positive group(2.56±0.85)cm was smaller than that in the CDX2 negative group[(3.41±0.93)cm](P<0.001).Compared with the CDX2 negative group,the propor-tion of patients with DX2 positive histological grade G2-G4 was lower(25.93%vs.66.67%),the tumor stage T3-T4 was lower(25.93%vs.66.67%),the proportion of lymphatic vessel vascular invasion(25.93%vs.66.67%),perineural invasion(14.81%vs.50.00%)and lymph node metastasis was lower(14.81%vs.61.11%)(P<0.05).The positive proportion of HER-2 expression(6.67%)was lower in CDX2 negative patients(50.00%)(P<0.05).The gene changes in CDX2 positive patients are mostly related to tyrosine kinase receptor(TRK)genes,including EGFR,ERBB2,ERBB3,DDR2 and MET,while those in CDX2 negative patients seem to be more closely related to changes in Tumor suppressor gene,including BRCA2,PETN,RB1,SMARCA4,TSC1 and ATRX.Conclusions Intestinal gastric adenocarcinoma has certain heteroge-neity and can be divided into two subtypes according to CDX2 expres-sion.CDX2-positive and CDX2-negative patients have different pathological and molecular characteristics and may have different prog-nosis,which is worthy of further study.