Prognostic significance of Cdx2 immunohistochemical expression in gastric cancer: A meta-analysis of published literatures

Cdx2 is a homeobox domain-containing transcription factor that is important in the development and differentiation of the intestinal cells,and served as a potential biomarker of tumor progression in early intestinal-type gastric cancer. however,its prognostic value and significance in gastric cancer remain controversial. a meta-analysis based on published studies was performed to obtain an accurate evaluation of the association between the presence of cdx2-positive in clinical samples and clinical outcome. a total of 13 eligible retrospective cohort studies with 1513 patients were included. cdx2-positive cases were significantly associated with higher male-to-female ratio (rr=1.27,95% ci: 1.17-1.38,p<0.00001 fixed-effect),lower (i+ii) clinical stage (rr=1.63,95% ci: 1.42-1.87,p<0.00001 fixed-effect),better histologic differentiation (rr=1.54,95% ci: 1.34-1.76,p<0.00001 fixed-effect),and lower rate of vascular invasion (rr=1.23,95% ci: 1.08-1.41,p=0.002 fixed-effect) and lymph node metastasis (rr=1.52,95% ci: 1.33-1.73,p<0.00001 fixed-effect),as well as higher 5-year survival rate (hr=2.22,95% ci: 1.78-2.75,p<0.00001 fixed-effect). however,the presence of cdx2 was not associated with tumor size. in summary,cdx2 is a prognostic factor in gastric cancer,which acts as a marker of good outcome in patients with gastric cancer. further clinical studies are needed to confirm the role of cdx2 in clinical practice. © 2012 wang et al.; licensee biomed central ltd.