SATB2 protein expression by immunohistochemistry is a sensitive and specific marker of appendiceal and rectosigmoid well differentiated neuroendocrine tumours

Abstract

Aims Neuroendocrine neoplasms (NNs) range from well to poorly differentiated and indolent to highly aggressive. The site of origin in metastatic NNs has therapeutic and prognostic implications. SATB2 is a transcriptional regulator involved in osteoblastic and neuronal differentiation and is a sensitive and specific marker of colorectal epithelium. This study aimed to evaluate the expression of SATB2 in NNs from various primary sites and its utility as a marker in determining the site of origin of these neoplasms. Methods and results SATB2 immunohistochemistry was performed on 266 NNs, including lung small cell carcinomas (n = 39) and carcinoids (n = 30), bladder (n = 21) and prostate (n = 31) small cell carcinomas, and gastrointestinal (GI)/pancreatic NNs of various primary sites (n = 145) consisting of well‐differentiated neuroendocrine tumours (WDNET)s (n = 124) and poorly differentiated neuroendocrine carcinomas (PDNEC)s (n = 21). SATB2 was expressed in prostatic (10 of 31, 32%) and bladder (eight of 21, 38%) small cell carcinomas, lung carcinoid tumours (one of 30, 3%), and lung small cell carcinomas (eight of 39, 21%). Among primary GI NNs, SATB2 was expressed in 37 of 124 (30%) WDNETs and four of 21 (19%) PDNECs. Of the former, 15 of 15 (100%) rectal/rectosigmoid and 22 of 22 (100%) appendiceal neoplasms expressed SATB2. Using receiver operator characteristic analysis, SATB2 was a sensitive and specific marker for rectal (100.0%, 80.0%) and appendiceal (100.0%, 84.5%) WDNETs, respectively. Conclusions In summary, SATB2 is a sensitive and specific marker for rectal/rectosigmoid and appendiceal WDNETs, and may represent a useful diagnostic tool when these sites of origin are considered in the differential diagnosis.

Expression of SATB2 in Neuroendocrine Carcinomas of the Lung: Frequent Immunopositivity of Large Cell Neuroendocrine Carcinoma with a Diagnostic Pitfall

“…5-7 Other studies have reported that SATB2 are positive in 53% of Genitourinary small cell carcinoma, 27% of colorectal NECs and 25% of Pancreatic NECs. 7,29 Similarly pulmonary SCLC or pulmonary NEC (details not shown) have shown the positive rate of SATB2 ranging from 21% to 33%. 5,7 Besides, a most recent study has reported the expression of SATB2 in pulmonary and thymic neuroendocrine tumors (carcinoid tumor and NEC), with a higher percentage of expression in SCLC comparing to the previous reports.…”

Infiltrating Ductal Breast Carcinoma Metastasized to the Rectum: A Case Report and a Review of the Literature

“…Bayrak R et al analyzed 118 colorectal, 59 gastric, and 32 pancreatic adenocarcinoma resection specimens and concluded that in colorectal adenocarcinomas, CDX2 expression and the CK7−/CK20 + pattern were highly sensitive and speci c [31] . SATB2, a recently described transcriptional regulator, is reported as a highly speci c and sensitive marker of colorectal cancer (CRC) [36,37] . Magnusson K et al reported that SATB2 plus CD20 + could detect over 95% of the CRC cases [37] .…”

Ductal breast carcinoma metastasized to the rectum: A case report and review of the literature

“…Bayrak et al [ 24 ] analyzed 118 colorectal, 59 gastric and 32 pancreatic adenocarcinoma resection specimens and concluded that in colorectal adenocarcinoma, CDX2 expression and the CK7 − /CK20 + pattern were highly sensitive and specific. SATB2, a recently described transcriptional regulator, is reported as a highly specific and sensitive marker of colorectal cancer (CRC)[ 27 ]. Magnusson et al [ 28 ] reported that SATB2 plus CD20 + could detect > 95% of the CRC cases.…”