ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2021
Mismatch repair phenotype determines the implications of tumor grade and CDX2 expression in stage II-III colon cancer.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 19 citations in OpenAlex.
- CDX2 confers ferroptosis resistance in stage II-III colon cancer via upregulation of NUPR1.Cell death & disease · 2026Article
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- CANDiT: A machine learning framework for differentiation therapy in colorectal cancer.Cell reports. Medicine · 2025Article
- Collagen disorder architecture features are associated with clinical, molecular, genetic factors and survival outcomes in colon cancer.NPJ precision oncology · 2025Article
- High-Resolution Spatial Proteomics Characterises Colorectal Cancer Consensus Molecular Subtypes.bioRxiv : the preprint server for biology · 2025Article
- CDX2 and SATB2 loss are associated with myeloid cell infiltration and poor survival in colorectal cancer.Cancer immunology, immunotherapy : CII · 2025Article
- The Prognostic and Predictive Utility of CDX2 in Colorectal Cancer.International journal of molecular sciences · 2024Article
- Evaluation of the Immunohistochemical Scoring System of CDX2 Expression as a Prognostic Biomarker in Colon Cancer.Diagnostics (Basel, Switzerland) · 2024Article
- The Prognostic Role of Mismatch Repair Status and CDX-2 Expression with Inflammatory Markers and Pathological Risk Factors in Stage II and III Colon Cancer: Multicenter Real-Life Data.Journal of gastrointestinal cancer · 2024Article
- Article
- Potential predictors for CDX2 expression loss and mismatch repair deficiency in colorectal cancer.Pathology oncology research : POR · 2023Article
- Effects of deficient mismatch repair on the prognosis of patients with stage II and stage III colon cancer during different postoperative periods.BMC cancer · 2022Article
- Diagnostic and Prognostic Roles of CDX2 Immunohistochemical Expression in Colorectal Cancers.Diagnostics (Basel, Switzerland) · 2022Article
- Stage-dependent prognostic shift in mismatch repair-deficient tumors: Assessing patient outcomes in stage II and III colon cancer.Frontiers in oncology · 2022Article
- Loss of CDX2 in colorectal cancer is associated with histopathologic subtypes and microsatellite instability but is prognostically inferior to hematoxylin-eosin-based morphologic parameters from the WHO classification.British journal of cancer · 2021Article
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Authors and funding
6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Mismatch repair (MMR) deficiency is an indicator of good prognosis in localized colon cancer but also associated with lack of expression of caudal-type homeobox transcription factor 2 (CDX2) and high tumor grade; markers that in isolation indicate a poor prognosis. Our study aims to identify clinically relevant prognostic subgroups by combining information about tumor grade, MMR phenotype, and CDX2 expression. Immunohistochemistry for MMR proteins and CDX2 was performed in 544 patients with colon cancer stage II-III, including a cohort from a randomized trial. In patients with proficient MMR (pMMR) and CDX2 negativity, hazard ratio (HR) for cancer death was 2.93 (95% CI 1.23-6.99, p = 0.015). Cancer-specific survival for pMMR/CDX2-negative cases was 35.8 months (95% CI 23.4-48.3) versus 52.1-53.5 months (95% CI 45.6-58.6, p = 0.001) for the remaining cases (CDX2-positive tumors or deficient MMR (dMMR)/CDX2-negative tumors). In our randomized cohort, high tumor grade was predictive of response to adjuvant fluorouracil-levamisole in pMMR patients, with a significant interaction between tumor grade and treatment (p = 0.036). For pMMR patients, high tumor grade was a significant marker of poor prognosis in the surgery-only group (HR 4.60 (95% CI 1.68-12.61), p = 0.003) but not in the group receiving chemotherapy (HR 0.66 (95% CI 0.15-3.00), p = 0.587). To conclude, patients with pMMR and CDX2 negativity have a very poor prognosis. Patients with pMMR and high-graded tumors have a poor prognosis but respond well to adjuvant chemotherapy. CDX2 expression and tumor grade did not impact prognosis in patients with dMMR.
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