CDX2 Overexpression in Barrett’s Esophagus and Esophageal Adenocarcinoma

Abstract

Background: Patients with Barrett's esophagus have an increased risk of developing esophageal adenocarcinoma. Our purpose was to determine CDX2 expression in esophageal mucosa and establish a correlation between this marker and the progression of disease. Methods: We analyzed biopsies and surgical specimens from 150 patients who were divided into five groups according to histopathological diagnosis: G1, normal mucosa (n = 29); G2, esophagitis (n = 19); G3, columnar epithelium without intestinal metaplasia (n = 26); G4, Barrett's esophagus (n = 32), and G5, adenocarcinoma (n = 44). Immuno-histochemical determination of CDX2 expression was considered positive in the presence of nuclear staining. Results: No CDX2 expression was detected in the G1 or G3 groups; 5% of G2, 62.5% of G4 and 70.5% of G5 patients were CDX2 positive. There was a statistically significant difference between the G4 and G5 groups compared to the G1, G2 and G3 (p < 0.05). Conclusions: CDX2 expression was observed among patients with Barrett's esophagus and adenocarcinoma compared to other groups. CDX2 was not expressed in the phases preceding Barrett's esophagus, but there was no linear correlation between CDX2 expression and metaplasia-adenocarcinoma progression.