Alphabetical Test listing

CDX2 by IHC-12376 - Technical only, 12379 - Technical & interpretation

12376 - Technical only, 12379 - Technical & interpretation

All IHC stains will include a positive control tissue

  • CDX2 is a specific and sensitive marker of normal and neoplastic intestinal epithelium, and thus is very useful in identifying a metastatic tumor of GI origin
  • Loss of CDX2 expression has been observed in poorly differentiated MSI colorectal carcinomas; these tumors have undergone mutation of the CDX2 gene, and thus the tumors appear as CDX2 negative
  • CDX2 can be used in a panel with CK7 and CK20, and will be extremely useful in colorectal tumors that show an aberrant CK7/CK20 profile (5-25% of cases), or in colorectal tumors that show only focal CK20 staining (can be a problem in small biopsies or cytologic specimens)

Submit a formalin-fixed, paraffin-embedded tissue


Formalin-fixed, paraffin-embedded (FFPE) tissue block


FFPE tissue section mounted on a charged, unstained slide


Ambient (preferred)

  • Unlabeled/mislabeled block
  • Insufficient tissue
  • Slides broken beyond repair
AHL - Immunohistochemistry
Mo - Fr
1 - 2 days

Immunohistochemical staining and microscopic examination


If requested, an interpretive report will be provided



  • CDX2 is a homeobox gene necessary for intestinal organogenesis, and encodes for nuclear transcription factors involved in proliferation and differentiation of intestinal epithelial cells
  • CDX2 is expressed in normal colonic epithelium, and in most colorectal adenocarcinomas (>95%)
  • CDX2 expression is seen in epithelial cells from duodenum to rectum, including absorptive, goblet, endocrine, and Paneth cells (and is seen in intestinal metaplastic cells of stomach)
  • CDX2 staining has also been identified in tumors of gallbladder (60%), pancreatic (60%), stomach (55%), and ovarian mucinous (64-100%) origin. Adenocarcinomas of the urinary bladder (2 of 2 cases; 100%) have also been shown to stain positive; rarely, CDX2 has been also reported in tumors from prostate and thyroid (papillary)
  • CDX2 expression can also be seen in lung cancers (reported in lung adenocarcinomas and large cell carcinomas)

Staining pattern

  • Nuclear based staining


  1. Barbarexchi M, et al: CDX2 homeobox gene expression is a reliable marker of colorectal adenocarcinoma metastases to the lungs. Am J Surg Pathol 27 (2): 141-149, 2003.
  2. Werling RW et al: CDX2, a highly sensitive and specific marker of adenocarcinomas of intestinal origin; an immunohistochemical survey of 476 primary and metastatic carcinomas. Am J Surg Pathol 27(3): 303-310, 2003.
  3. Mazziotta RM et al: CDX2 immunostaining as a gastrointestinal marker: expression in lung carcinomas is a potential pitfall. Appl Immunohostochem Mol Morphol 2005 Mar; 13(1):55-60.
88342 - 1st stain
88341 - each additional stain