Schmitt Maxime, Silva Miguel, Konukiewitz Björn, Lang Corinna, Steiger Katja, Halfter Kathrin, Engel Jutta, Jank Paul, Pfarr Nicole, Wilhelm Dirk, Foersch Sebastian, Denkert Carsten, Tschurtschenthaler Markus, Weichert Wilko, Jesinghaus Moritz
Institute of Pathology, University Hospital Marburg, 35043 Marburg, Germany.
Institute of Pathology, Technical University Munich, 81675 Munich, Germany.
Cancers (Basel). 2021 Dec 7;13(24):6177. doi: 10.3390/cancers13246177.
Special AT-rich sequence-binding protein 2 (SATB2) has emerged as an alternative immunohistochemical marker to CDX2 for colorectal differentiation. However, the distribution and prognostic relevance of SATB2 expression in colorectal carcinoma (CRC) have to be further elucidated.
SATB2 expression was analysed in 1039 CRCs and correlated with clinicopathological and morphological factors, CDX2 expression as well as survival parameters within the overall cohort and in clinicopathological subgroups.
SATB2 loss was a strong prognosticator in univariate analyses of the overall cohort ( < 0.001 for all survival comparisons) and in numerous subcohorts including high-risk scenarios (UICC stage III/high tumour budding). SATB2 retained its prognostic relevance in multivariate analyses of these high-risk scenarios (e.g., UICC stage III: DSS: = 0.007, HR: 1.95), but not in the overall cohort (DSS: = 0.1, HR: 1.25). SATB2 loss was more frequent than CDX2 loss (22.2% vs. 10.2%, < 0.001) and of higher prognostic relevance with only moderate overlap between SATB2/CDX2 expression groups.
SATB2 loss is able to identify especially aggressive CRCs in high-risk subgroups. While SATB2 is the prognostically superior immunohistochemical parameter compared to CDX2 in univariate analyses, it appears to be the less sensitive marker for colorectal differentiation as it is lost more frequently.
富含AT序列结合蛋白2（SATB2）已成为一种用于结直肠分化的替代免疫组化标志物，可替代CDX2。然而，SATB2在结直肠癌（CRC）中的表达分布及其与预后的相关性仍有待进一步阐明。
对1039例结直肠癌患者的SATB2表达进行分析，并与临床病理和形态学因素、CDX2表达以及整个队列和临床病理亚组中的生存参数进行关联分析。
在整个队列的单因素分析中（所有生存比较的P<0.001）以及在包括高风险情况（UICC III期/高肿瘤芽生）在内的众多亚组中，SATB2缺失是一个强有力的预后指标。在这些高风险情况的多因素分析中，SATB2保留了其预后相关性（例如，UICC III期：疾病特异性生存：P = 0.007，风险比：1.95），但在整个队列中则不然（疾病特异性生存：P = 0.1，风险比：1.25）。SATB2缺失比CDX2缺失更常见（22.2%对10.2%，P<0.001），且预后相关性更高，SATB2/CDX2表达组之间仅有适度重叠。
SATB2缺失能够在高风险亚组中识别出侵袭性特别强的结直肠癌患者。虽然在单因素分析中，与CDX2相比，SATB2是预后方面更优的免疫组化参数，但由于其缺失更为频繁，它似乎是结直肠分化敏感性较低的标志物。
