The Expression And Significance Of CDX2 And MUC2 In Extrahepatic Cholangiocarcinoma

Objective:To study the expression of the caudal type homebox transcription factor 2 (CDX2) and mucin 2(MUC2) in extrahepatic cholangiocarcinoma and to explore the relationship between them and the clinical pathologic factors which include the differentiation degrade and invasive capacity of carcinoma cell, the TNM stage grouping, etc.To investigate and elucidate the interrelation among CDX2, MUC2 and their role played in the mechanism of tumorigenesis and tumor progression.Methods:42 cholangiocarcinomas were selected from the patients who had performed operation and leaved the specimens of the bile duct tissures in the First Affiliated Hospital of Nanchang University between 2006.4 and 2010.11. All of the patients didn't received any form of radiaotherapy, chemotherapy and immunotherapy before operation.42 non-carcinomas cases were selected mostly from the patients who had the operation for cholangiocarcinoma or the liver transplantation, the left were the patients who had the operation for the emergency abdominal injury or the benign lesion of extrahepatic bile duct. Immunohistochemical technique MaxVisionTM2/HRP was carried out to detect the expression of CDX2 and MUC2 in the extrahepatic cholangiocarcinoma tissues and non-carcinoma extrahepatic bile duct tissues.Results:1,We observed that the positivity rate of CDX2 and MUC2 expressions were 16.67%(7/42)and 30.95%(13/42) in the extrahepatic cholangiocarcinoma cases respectively. CDX2 didn't express in the non-carcinoma cases. The positivity rate of MUC2 expressions in the non-carcinoma cases were 0.02%(1/42). There are significant differences between the cholangiocarcinoma group and non-carcinoma group(PCDX2<0.05, PMUC2<0.01). And there was a positive correlation between the expressions of CDX2 and MUC2 (r=0.668, P<0.01)2,The positive expression of CDX2 in the extrahepatic cholangiocarcinoma was significantly different for the different pathological grade(P<0.05), and the positivity would be higher in the higher pathological grade. However the patients'age and sexual distinction, the tumor invasive capacity and the TNM stage grouping had no significant relationship with the positiviy of CDX2. While the positive expression of MUC2 in the cholangiocarcinoma was only significantly different according to the tumor'differentiation degrade(P<0.05), invasive capacity of carcinoma cell(P<0.01)and the TNM stage grouping(P<0.05). Increasing expression of MUC2 with the higher tumor differentiation degrade, TNM stages increasing, and adjacent organ invasion.3, After the statistical analysis of the clinical data, we found that the site tumor locate in had close relationship with the the tumor invasive capacity (P<0.01) and the TNM stage grouping (P<0.01). The distal cholangiocarcinoma was more likely to have adjacent organ invasion and higher TNM stage than the perihilar cholangiocarcinoma. There were no other significant differences between the rest clinical and pathological data.Conclusions:1,The up-regulation of CDX2 and MUC2 expression in the extrahepatic cholangiocarcinoma group indicates their participation in the mechanism of tumorigenesis and tumor progression. And the CDX2 plays the role in regulating and controlling of the MUC2 expression.2,The expression of CDX2 and MUC2 have close relationship with the tumor invasive capacity and the clinical prognosis.3,The joint detection of CDX2 and MUC2 is useful for the early diagnosis, treatment decision and prognosis judgement on the extrahepatic cholangiocarcinoma.