Research Papers:

CDX2 expression is concordant between primary colorectal cancer lesions and corresponding liver metastases independent of chemotherapy: a single-center retrospective study in Japan

Yasuyuki Shigematsu _, Kentaro Inamura, Yoshihiro Mise, Akio Saiura, Emil Rehnberg, Noriko Yamamoto, Yuichi Ishikawa, Shunji Takahashi and Hiroaki Kanda

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Oncotarget. 2018; 9:17056-17065. https://doi.org/10.18632/oncotarget.24842

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Yasuyuki Shigematsu1, Kentaro Inamura1, Yoshihiro Mise2, Akio Saiura2, Emil Rehnberg3, Noriko Yamamoto1, Yuichi Ishikawa1, Shunji Takahashi4 and Hiroaki Kanda1

1Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research (JFCR), Koto, Tokyo 135-8550, Japan

2Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Koto, Tokyo 135-8550, Japan

3Division of Business Intelligence, Labs BI, Shanghai 200040, China

4Division of General Oncology, The Cancer Institute Hospital, JFCR, Koto, Tokyo 135-8550, Japan

Correspondence to:

Yasuyuki Shigematsu, email: yasuyuki.shigematsu@jfcr.or.jp

Keywords: CDX2; heterogeneity; colorectal cancer; chemotherapy; liver metastasis

Received: June 05, 2017     Accepted: February 28, 2018     Published: March 30, 2018


Objective: Loss of caudal-type homeobox transcription factor 2 (CDX2) expression in colorectal cancers (CRCs) has recently been proposed as a promising predictive biomarker for not only prognosis but also response to chemotherapy. However, the relationship between alterations in CDX2 expression during cancer progression and response to chemotherapy remains unclear. We herein aimed to determine the concordance of CDX2 expression between primary CRCs and corresponding liver metastases, in association with chemotherapy.

Results: Primary CRCs exhibited heterogeneous CDX2 expression. Seven of the 144 CRCs in the cohort (4.9%, 95% confidential interval, 2.0%–9.8%) were CDX2-negative. The concordance rate of the CDX2 expression status in patients who did not receive chemotherapy was 100% (P = 0.041), whereas the concordance rate among patients who received chemotherapy only after primary resection was 96.3% (P = 0.005). Moreover, the concordance rate in patients who received chemotherapy before both primary resection and liver metastasectomy was 100% (P < 0.001).

Conclusion: CDX2 expression status was highly concordant between primary CRCs and corresponding liver metastases, independent of chemotherapy, suggesting that the CDX2 expression status in CRCs was not affected by metastasis or chemotherapy.

Methods: A total of 144 consecutive patients with CRC who were treated at a single center in Japan between 2006 and 2014 were included. Formalin-fixed paraffin-embedded whole sections of surgically resected primary CRCs and corresponding liver metastases were assessed for CDX2 expression by immunohistochemistry.

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