The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer

How to cite: Chan, W. Y.; Chua, W.; Wilkinson, K.; Epitakaduwa, C.; Mandaliya, H.; Descallar, J.; Roberts, T. L.; Becker, T. M.; Ng, W.; Lee, C. S.; Lim, S. H. The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer. Preprints 2024, 2024071687. https://doi.org/10.20944/preprints202407.1687.v1 Chan, W. Y.; Chua, W.; Wilkinson, K.; Epitakaduwa, C.; Mandaliya, H.; Descallar, J.; Roberts, T. L.; Becker, T. M.; Ng, W.; Lee, C. S.; Lim, S. H. The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer. Preprints 2024, 2024071687. https://doi.org/10.20944/preprints202407.1687.v1

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MDPI and ACS Style

Chan, W. Y.; Chua, W.; Wilkinson, K.; Epitakaduwa, C.; Mandaliya, H.; Descallar, J.; Roberts, T. L.; Becker, T. M.; Ng, W.; Lee, C. S.; Lim, S. H. The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer. Preprints 2024, 2024071687. https://doi.org/10.20944/preprints202407.1687.v1

APA Style

Chan, W. Y., Chua, W., Wilkinson, K., Epitakaduwa, C., Mandaliya, H., Descallar, J., Roberts, T. L., Becker, T. M., Ng, W., Lee, C. S., & Lim, S. H. (2024). The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer. Preprints. https://doi.org/10.20944/preprints202407.1687.v1

Chicago/Turabian Style

Chan, W. Y., Cheok Soon Lee and Stephanie Hui Lim. 2024 "The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer" Preprints. https://doi.org/10.20944/preprints202407.1687.v1

Abstract

Caudal type homeobox transcription factor 2 (CDX2) is a gastrointestinal cancer biomarker that regulates epithelial development and differentiation. Absence or low levels of CDX2 have been associated with poor prognosis and proposed as a chemotherapy response predictor. Tumour tissue of 668 patients with stage I-IV colorectal cancer were stained for CDX2 and stratified into two subgroups according to expression levels. Statistical tests evaluated CDX2 relationship with survival and chemotherapy response. Of 646 samples successfully stained, 51 (7.9%) had low and 595 (92.1%) had high CDX2 levels. Low CDX2 staining was associated with poor differentiation, presence of lymphovascular or perineural invasion, and more common in colon and right sided tumours. Overall survival (p<0.001) and disease-free survival (p=0.009) was lower in low CDX2 expressing patients. Multivariable analysis validated CDX2 as an independent poor prognostic factor after excluding confounding variables. There was no statistically significant improvement in survival with adjuvant chemotherapy in stage II colon cancer (p=0.11). In the rectal cohort, there was no relationship between CDX2 levels and therapy response. While confirming the prognostic utility of CDX2 in colorectal cancer, our study highlights larger studies are required to confirm utility as a predictive chemotherapy biomarker, especially in left sided and rectal cancers.

Keywords

colorectal cancer; caudal type homeobox transcription factor 2; biomarkers; prognostic; predictive; chemotherapy

Subject

Biology and Life Sciences, Biochemistry and Molecular Biology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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