Expression And Its Clinical Significance Of CDX2 And Hep In Barrett's Esophagus

Objective To analyse the expression of caudal type homeobox transcription factor 2(CDX2) and hepatocyte antigen (Hep) in reflux esophagitis (RE), Barrett's esophagus (BE) and esophageal adenocarcinoma (EA). To study the action of CDX2 and Hep in the development of BE and its Clinical Significance. Methods The study consists of 25 biopsies of RE, 60 biopsies of BE (gastric-type BE 22; cardiac-type BE 20; intestinal-metaplasia-type BE 18), 20 biopsies of EA. 10 biopsies of normal esophageal and 10 biopsies of normal cardia as normal control. Using immunohistochemistry (EliVisionTMplus), the expression of CDX2 and Hep were detected in every group mucosa. Statistical analysis was performed using SPSS 13.0 software. Results CDX2 express in the nucleus and Hep express in the cytoplasm. CDX2 and Hep express in both Superficial mucosal and deep mucosal in positive group. There was no expression of CDX2 and Hep in normal esophageal and normal cardia. The positive rate of CDX2 in RE, gastric-type BE, cardiac-type BE, intestinal-metaplasia-type BE and EA expression were 20.0% (5/25), 31.8% (7/22), 35.0%(7/20), 100.0%(18/18) and 70.0%(14/20). The expression of intestinal- metaphase-type BE were higher than those of other groups (P<0.05). There was no difference between RE, gastric-type BE and cardiac-type BE (P>0.05). The expression of EA were lower than intestinal-metaplasia-type BE, higher than those of other groups (P<0.05). There was no expression of Hep in RE, gastric-type BE and cardiac-type BE. The positive rate of Hep in intestinal-metaplasia-type BE expression were 100% (18/18), in EA were 65.0% (13/20). The expression of intestinal-metaplasia-type BE were higher than EA (P<0.05). Expression intensity of CDX2 and Hep in every group consistent with the positive rate. The positive rate of CDX2 and Hep in every group have positive correlation. Conclusions①CDX2 and Hep were important makers that induced normal cell to intestinal metaplasia. CDX2 and Hep May be involved in evolution from RE to BE and then to EA.②Sensitivity of CDX2 and Hep expression were high in intestinal-metaplasia-type BE, and Hep also have high specificity. CDX2 can be thought of as an early marker of BE, and Hep can be thought of as a specific marker of intestinal-metaplasia-type BE.