Open AccessCDX2 as a marker for intestinal differentiation: Its utility and limitations
Author(s) -
Reda S. Saad,
Zeina Ghorab,
Mahmoud A. Khalifa,
Xu Mei
Publication year - 2011
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v3.i11.159
Subject(s) - cdx2 , homeobox a1 , homeobox , homeobox protein nkx 2.5 , gastrointestinal tract , embryonic stem cell , biology , dlx5 , transcription factor , emx2 , cancer research , cellular differentiation , gene , genetics , biochemistry
CDX2 is a nuclear homeobox transcription factor that belongs to the caudal-related family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play an essential role in the control of normal embryonic development. CDX2 is crucial for axial patterning of the alimentary tract during embryonic development and is involved in the processes of intestinal cell proliferation, differentiation, adhesion, and apoptosis. It is considered specific for enterocytes and has been used for the diagnosis of primary and metastatic colorectal adenocarcinoma. CDX2 expression has been reported to be organ specific and is normally expressed throughout embryonic and postnatal life within the nuclei of epithelial cells of the alimentary tract from the proximal duodenum to the distal rectum. In this review, the authors elaborate on the diagnostic utility of CDX2 in gastrointestinal tumors and other neoplasms with intestinal differentiation. Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed.