Department of Pathology, New York Langone Medical Center, New York, NY, USA.
Department of Pathology, Urology and Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Histopathology. 2020 Mar;76(4):550-559. doi: 10.1111/his.14012. Epub 2020 Jan 24.
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.
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.
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.
神经内分泌肿瘤（NNs）从分化良好到分化不良，从惰性到高度侵袭性不等。转移性 NNs 的起源部位与治疗和预后有关。SATB2 是一种参与成骨细胞和神经元分化的转录调节因子，是结直肠上皮的敏感和特异性标志物。本研究旨在评估 SATB2 在来自不同原发部位的 NNs 中的表达，并评估其作为确定这些肿瘤起源部位的标志物的效用。
对 266 例 NNs 进行 SATB2 免疫组化染色，包括肺小细胞癌（n=39）和类癌（n=30）、膀胱（n=21）和前列腺（n=31）小细胞癌，以及来自不同原发部位的胃肠道（GI）/胰腺 NNs（n=145），包括分化良好的神经内分泌肿瘤（WDNET）（n=124）和分化不良的神经内分泌癌（PDNEC）（n=21）。SATB2 在前列腺（31 例中的 10 例，32%）和膀胱（21 例中的 8 例，38%）小细胞癌、肺类癌肿瘤（30 例中的 1 例，3%）和肺小细胞癌（39 例中的 8 例，21%）中表达。在原发性 GI NNs 中，SATB2 在 124 例 WDNET 中的 37 例（30%）和 21 例 PDNEC 中的 4 例（19%）中表达。其中，15 例（100%）直肠/直肠乙状结肠和 22 例（100%）阑尾肿瘤表达 SATB2。通过接受者操作特征分析，SATB2 是直肠（100.0%，80.0%）和阑尾（100.0%，84.5%）WDNET 的敏感和特异性标志物。
总之，SATB2 是直肠/直肠乙状结肠和阑尾 WDNET 的敏感和特异性标志物，当考虑这些起源部位在鉴别诊断中时，可能代表一种有用的诊断工具。
