배경 및 목적 : Caudal-type homeobox gene family인 CDX1과 CDX2는 장상피세포의 증식 및 분화를 조절하는데에 중요한 역할을 하는 유전자로 대장암에서 발현이 감소되는 것으로 알려져 있다. 현재까지 CDX1 및 CDX2 발현 정도가 대장암의 임상병리학적 인자에 미치는 영향에 대한 연구는 드물다. 이에 본 연구에서는 대장암에서 CDX1 mRNA 및 CDX2 mRNA 발현 정도를 조사하여 임상병리학적 인자와의 연관성을 알아보고자 하였다. 대상 및 방법 : 2002년 7월부터 2003년 3월까지 부산대학교 병원에서 대장암으로 진단된 48명을 대상으로 하였다. 대장암과 대장암에 인접한 비종양성 정상 점막에서의 CDX1 mRNA 및 CDX2 mRNA 발현을 real- time PCR법으로 분석하였으며, 환자의 성별, 연령, 종양의 위치, 분화도, 혈관 및 림프관 침범 유무, 림프절 전이 유무, Astler-Coller 분류법에 의한 병기, 수술 전 CEA 수치에 따른 CDX1 mRNA 및 CDX2 mRNA 발현을 조사하였다. 결과 : 대장암에서 CDX1 mRNA의 발현은 정상 점막보다 의미있게 감소하였고(0.043±0.599 vs 0.110±0.182, p=0.001), CDX2 mRNA의 발현도 의미 있게 감소하였다(0.265±0.234 vs 0.360±0.362, p=0.042). 대장암에서 CDX1 mRNA 및 CDX2 mRNA의 발현이 정상 점막보다 감소한 경우는 각각 64.6% (31/48), 66.7% (32/48)였으며 CDX1 mRNA와 CDX1 mRNA의 발현이 모두 감소된 경우는 50.0% (24/48)였다. 대장암에서 CDX1 mRNA 발현과 CDX2 mRNA 발현을 비교했을 때 정상 점막에 대한 CDX1 mRNA 발현의 증감 정도와 CDX2 mRNA 발현의 증감 정도 사이에는 통계적으로 유의한 상관성이 관찰되었다(r=0.543, p<0.001). CDX1 mRNA 및 CDX2 mRNA 발현과 환자의 성별, 연령, 종양의 위치, 분화도, 혈관 및 림프관 침범, 림프절 전이, 병기, 수술 전 CEA 수치 사이에는 연관성이 없었다. 결론 : 대장암에서 CDX1 mRNA 및 CDX2 mRNA 발현은 정상 점막에 비해 감소되었으며, 임상병리학적 인자와의 연관성은 없었다. 하지만 일부 대장암에서 CDX1 mRNA 및 CDX2 mRNA 발현이 증가되어 있어 대장암 발생과정에서 CDX1과 CDX2의 역할에 대해서는 더 많은 연구가 필요할 것으로 사료된다.

Background : CDX1 and CDX2, members of the caudal-type homeobox gene family, control proliferation and differentiation of intestinal mucosal cells. Their expression is reduced commonly in colorectal cancers, but reports about the relationship between their expression and the clinicopathologic features are rare. The aim of this study was to examine CDX1 mRNA and CDX2 mRNA expression in colorectal cancers and to assess the relationship between their expression and the clinicopathologic features. Methods : CDX1 mRNA and CDX2 mRNA expression were analyzed by real-time polymerase chain reaction in 48 colorectal cancers and their adjacent non-tumorous normal mucosas. Results : CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers than in normal mucosas (p=0.001, p=0.042, respectively). In comparison with paired normal mucosas, colorectal cancers showed decreased CDX1 mRNA expression in 64.6% (31/48) and decreased CDX2 mRNA expression in 66.7% (32/48). There was a statistically significant correlation between CDX1 mRNA and CDX2 mRNA expression in colorectal cancers (r=0.543, p<0.001). CDX1 mRNA and CDX2 mRNA expression were not related to age, sex, location of cancer, differentiation, lymphatic or vascular invasion, lymph node metastasis, stage and serum carcinoembryonic antigen level in colorectal cancers. Conclusion : CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers, but were not related to the clininopathologic features.

Background : CDX1 and CDX2, members of the caudal-type homeobox gene family, control proliferation and differentiation of intestinal mucosal cells. Their expression is reduced commonly in colorectal cancers, but reports about the relationship between their expression and the clinicopathologic features are rare. The aim of this study was to examine CDX1 mRNA and CDX2 mRNA expression in colorectal cancers and to assess the relationship between their expression and the clinicopathologic features. Methods : CDX1 mRNA and CDX2 mRNA expression were analyzed by real-time polymerase chain reaction in 48 colorectal cancers and their adjacent non-tumorous normal mucosas. Results : CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers than in normal mucosas (p=0.001, p=0.042, respectively). In comparison with paired normal mucosas, colorectal cancers showed decreased CDX1 mRNA expression in 64.6% (31/48) and decreased CDX2 mRNA expression in 66.7% (32/48). There was a statistically significant correlation between CDX1 mRNA and CDX2 mRNA expression in colorectal cancers (r=0.543, p<0.001). CDX1 mRNA and CDX2 mRNA expression were not related to age, sex, location of cancer, differentiation, lymphatic or vascular invasion, lymph node metastasis, stage and serum carcinoembryonic antigen level in colorectal cancers. Conclusion : CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers, but were not related to the clininopathologic features.

Colorectal cancers; Homeobox genes; CDX1; CDX2; Expression