Loss of special AT ‐rich sequence‐binding protein 1 ( SATB 1) predicts poor survival in patients with colorectal cancer

Aim Special AT ‐rich sequence‐binding protein 1 ( SATB 1) is a cell type‐specific matrix attachment region binding protein, functioning as a global genome organizer. This study aims to investigate the expression pattern and the prognostic value of SATB 1 in colorectal cancer. Methods and results Prospectively collected data were obtained and tissue microarrays were constructed from a cohort of 352 patients. SATB 1 protein expression was evaluated by immunohistochemistry and scored by two independent investigators. SATB 1 expression was predominantly nuclear in both normal and cancer tissues. Loss of SATB 1 nuclear expression was seen in 22% of colorectal cancers compared to 1.5% of adjacent normal colorectal tissue, and was associated with worse overall survival ( P  =   0.02) independent of age and stage of disease ( HR 2.48 with 95% CI 1.31–4.70). Loss of SATB 1 expression was more evident in younger patients ( P  =   0.03), tumours with mucinous or signet ring histology ( P  =   0.0001) and poor differentiation ( P  =   0.005). SATB 1 expression was associated with a survival advantage in patients with Dukes C tumours who received adjuvant chemotherapy. Conclusion Loss of SATB 1 nuclear expression correlates with poor survival and a less favourable response to adjuvant chemotherapy in colorectal cancer. The value of SATB 1 in individualized colorectal cancer therapy warrants further evaluation.