Immunohistochemical assessment for Cdx2 expression in the Barrett metaplasia-dysplasia-adenocarcinoma sequence

Abstract

Background: Barrett oesophagus (BO) occurs as a consequence of prolonged gastro-oesophageal reflux and it may precede the development of oesophageal adenocarcinoma.

Aims: The aim of this study was to accurately assess Cdx2 expression in the oesophageal metaplasia-dysplasia-adenocarcinoma sequence.

Method: The expression of the transcription factor Cdx2 in Barrett metaplasia, high-grade glandular dysplasia and adenocarcinoma was investigated using immunohistochemistry.

Results: The results confirmed previous immunohistochemistry and PCR-based investigations, indicating that Cdx2 was expressed by intestinal metaplasia in the oesophagus. In addition, upregulation followed by linear downregulation of Cdx2 expression through the oesophageal metaplasia-dysplasia-adenocarcinoma sequence was demonstrated for the first time.

Conclusion: Such downregulation of Cdx2 expression could be in keeping with a role as a tumour suppressor gene, but a simpler explanation would be downregulation of a differentiation marker.