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SATB 2 is a supplementary immunohistochemical marker to CDX 2 in the diagnosis of colorectal carcinoma metastasis in an unknown primary
Author(s) -
Dabir Parag Deepak,
Svanholm Hans,
Christiansen Jens Johannes
Publication year - 2018
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12854
Subject(s) - metastasis , medicine , immunohistochemistry , adenocarcinoma , colorectal cancer , pathology , rectum , carcinoma , cancer
CDX 2 is routinely used for identifying gastrointestinal origin of metastatic adenocarcinomas; but a high percentage of other carcinomas also show positivity with this antibody. SATB 2 is a new immunohistochemical marker with a few studies showing that it is specifically expressed in a large majority of colorectal adenocarcinomas. We assessed SATB 2 along with CDX 2 in patient material with metastasis in order to determine whether the primary site could be identified as ‘colon‐rectum’. Metastasis in 67 liver biopsies, 108 lymph nodes from resection specimens and 36 serous effusions was analyzed retrospectively. Blinded slides stained for CDX 2 and SATB 2 were assessed individually by two pathologists and sensitivity, specificity and kappa statistics were calculated. Sensitivity for CDX 2 in metastasis from colorectal adenocarcinomas was 93%; while in SATB 2 it was 79%. The combination of CDX 2 and SATB 2 yielded a sensitivity of 79% and a high specificity of 93%. There was an acceptable level of agreement (κ = 0.64) between the pathologists for both the markers in case of colorectal adenocarcinoma metastasis. CDX 2 is a sensitive marker compared to SATB 2; while the specificity of combination of CDX 2 and SATB 2 is high for metastasis from colorectal adenocarcinoma. SATB 2 can be used as a supplementary marker along with CDX 2 to identify colorectal origin for material received from patients clinically presenting with metastasis.