Author: Nat Pernick, M.D. (see Authors page)

Revised: 23 November 2015, last major update December 2011

Copyright: (c) 2003-2015,, Inc.

PubMed Search: CDX2[title]
Definition / General
  • Homeobox gene that encodes a nuclear transcription factor critical for intestinal embryonic development; relatively specific for intestinal epithelium (but see positive staining below)
  • Also called caudal-related homeobox gene 2, caudal type homeobox transcription factor 2
  • Homologue of Drosophila melanogaster homeobox gene-caudal
Uses by Pathologists
Micro Images

Images hosted on other servers:

Anal gland carcinoma is CDX2- with positive internal control of normal colonic glands (fig E)

Left-bladder adenocarcinoma is CDX2+ (fig C)

Left: primary colorectal carcinomas; middle: secondary colonic tumors; right: metastasis to brain (fig 2B)

Colonic medullary carcinoma is usually CDX2- (fig C), but colonic poorly differentiated carcinoma is usually CDX2+ (fig D)

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Stomach: poorly differentiated carcinoma (fig 4E)

Various (left to right): well-differentiated neuroendocrine carcinoma of pancreas, endometrial adenocarcinoma, hepatocellular carcinoma

Quality control of CDX2 staining

Carcinoid tumors: primary and metastatic

Images hosted on
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Secondary colorectal carcinoma to bladder is CDX2+ vs. primary bladder tumor is weak / negative

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Left: tissue microarrays of colonic adenoma, colorectal adenocarcinomas, ovarina carcinoma; right: carcinomas of colon, duodenum and ampulla

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Esophagus with Barrett esophagus: left-foveolar type dysplasia, right-adenomatous type dysplasia

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Esophagus with columnar lined epithelium with and without Barrett metaplasia

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Ovarian tumors (left to right): primary ovarian mucinous tumor, metastatic colorectal carcinoma, metastatic pancreatic carcinoma

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Ovarian tumors (left to right): primary mucinous ovarian adenocarcinoma, primary endometrioid adenocarcinoma with squamous metaplasia, metastatic colorectal carcinoma

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Stomach: epithelial dysplasia-left (fig E, E1) versus carcinoma-right

Positive Staining - Normal
  • Nuclei of intestinal epithelium lining colonic villi and crypts, subset of epithelium of pancreas, stomach, esophagus
  • Urachal remants of glandular type, bladder intestinal metaplasia
Positive Staining - Disease
Negative Staining