Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pathology

Objectives: Evaluation of the expression and significance of caudal- related homebox transcription factor (CDX2) in different gastric lesions including gastric carcinoma, intestinal metaplasia and H. pylori associated lesions. Material and methods: Sixty five cases enrolled in this work including twenty five cases of partial gastrectomy and thirty eight cases of gastric endoscopic biopsies and two cases of colonic tissue biopsies (positive control). Each case was studied using monoclonal antibody for CDX2 and scored as positive nuclear brown staining of lining glandular epithelial cells. Results: Regarding age distribution, the highest frequency in chronic gastritis was 7th decade and in gastric carcinoma was 5th decade. Males were predominant among different gastric lesions (65.7%). Among chronic gastritis cases, 50% were associated with H. pylori infection and 65.8% of cases had moderate intensity of inflammation. All dysplastic cases were associated with intestinal metaplasia. Fifty five percent of cases of positive CDX2 expression in chronic gastritis were associated with H. pylori.Eigty percent of dysplastic cases showed strong CDX2 intensity. Ninety two percent of gastric carcinoma cases were positive for CDX2 expression. ConclusIons: H. pylori infection plays a multistep progression from chronic gastritis to intestinal metaplasia to dysplasia and to gastric carcinoma.CDX2 positivity is found in H. pylori infection, intestinal metaplasia, dysplasia, low and high grade gastric carcinoma and positive vascular emboli cases and metastatic lymph nodes

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