Machado Isidro, Navarro Samuel, Picci Piero, Llombart-Bosch Antonio
Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain.
Pathology Department, University of Valencia, Valencia, Spain.
Pathol Res Pract. 2016 Sep;212(9):811-6. doi: 10.1016/j.prp.2016.06.012. Epub 2016 Jun 26.
SATB2 is commonly expressed in osteosarcomas. Although apparently being a valuable diagnostic marker for differentiating between small cell osteosarcoma (SCO) and other small round cell tumors of bone, for instance Ewing sarcoma family of tumors (ESFT), it has not been tested in a large series of ESFT and chondrosarcomas so far. We studied the immunohistochemical expression of SATB2 in 42 osteosarcomas, 31 chondrosarcomas, and 371 genetically confirmed ESFT. SATB2 positivity was detected in 90.4% of osteosarcomas, 87.5% of SCO, 91.3% of osteoblastic osteosarcomas, and in all chondroblastic and parosteal osteosarcomas. The osteoblastic and SCO subtypes expressed SATB2 more intensely than other histological types. SATB2 was expressed in 46.6% of chondrosarcomas, and in 1.3% of ESFT. Sensitivity and specificity of SATB2 immunoexpression were 90.4% and 95.3%, respectively. The positive and negative predictive values in osteosarcoma diagnosis were 66.6% and 98.9%, respectively. In chondrosarcoma, SATB2 immunoexpression was more frequent and intense in high-grade chondrosarcoma (Grade III) and uncommon in chondrosarcoma grade I. SATB2 positivity was detected in 55.6% of chondrosarcomas grade II. SATB2 apparently cannot distinguish between chondroblastic osteosarcoma and high-grade chondrosarcoma. Nevertheless, SATB2 is frequently expressed in osteogenic tumors, but is rarely positive in ESFT, and with the support of CD99 expression and specific molecular studies, it is very useful for distinguishing between these two lesions. Although SATB2 immunoexpression helps to distinguish osteosarcoma from their mimickers, the identification of malignant osteoid matrix formation and the integration of clinical and radiological data remain the corner stone of osteosarcoma diagnosis and as yet no antibody has equalled the diagnostic value of this important morphologic hallmark.
SATB2在骨肉瘤中普遍表达。尽管它显然是区分小细胞骨肉瘤（SCO）与其他骨的小圆细胞肿瘤（如尤因肉瘤家族性肿瘤（ESFT））的一个有价值的诊断标志物，但到目前为止尚未在大量的ESFT和软骨肉瘤中进行检测。我们研究了SATB2在42例骨肉瘤、31例软骨肉瘤和371例经基因确诊的ESFT中的免疫组化表达情况。在90.4%的骨肉瘤、87.5%的SCO、91.3%的成骨细胞性骨肉瘤以及所有的软骨母细胞性和骨旁骨肉瘤中检测到SATB2阳性。成骨细胞性和SCO亚型比其他组织学类型更强烈地表达SATB2。SATB2在46.6%的软骨肉瘤和1.3%的ESFT中表达。SATB2免疫表达的敏感性和特异性分别为90.4%和95.3%。在骨肉瘤诊断中的阳性和阴性预测值分别为66.6%和98.9%。在软骨肉瘤中，SATB2免疫表达在高级别软骨肉瘤（III级）中更频繁且强烈，在I级软骨肉瘤中不常见。在II级软骨肉瘤中检测到SATB2阳性的比例为55.6%。SATB2显然无法区分软骨母细胞性骨肉瘤和高级别软骨肉瘤。然而，SATB2在成骨性肿瘤中经常表达，但在ESFT中很少呈阳性，并且在CD99表达和特定分子研究的支持下，它对于区分这两种病变非常有用。尽管SATB2免疫表达有助于将骨肉瘤与其模仿者区分开来，但恶性骨样基质形成的识别以及临床和放射学数据的整合仍然是骨肉瘤诊断的基石，并且到目前为止还没有抗体能与这一重要形态学标志的诊断价值相媲美。
