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15/12/2025
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Lê, M. H., Lý, T. T., Lưu, T. T. T., Phạm, V. H., & Giang, M. N. (2025). EVALUATION OF SATB2 EXPRESSION IN PRIMARY TUMORS AND CORRESPONDING LYMPH NODE METASTASES OF COLORECTAL ADENOCARCINOMA. Vietnam Medical Journal, 556(3). https://doi.org/10.51298/vmj.v556i3.16474
EVALUATION OF SATB2 EXPRESSION IN PRIMARY TUMORS AND CORRESPONDING LYMPH NODE METASTASES OF COLORECTAL ADENOCARCINOMA
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Abstract
Background: SATB2 is an immunohistochemical marker with high sensitivity and specificity for colorectal adenocarcinoma. In the diagnosis of metastatic lesions of unknown origin, SATB2 is highly valuable in routine practice. However, data on the concordance of SATB2 expression between primary tumors and regional lymph node metastases remain limited. Objective: To evaluate SATB2 expression in primary tumors and corresponding lymph node metastases of colorectal adenocarcinoma, and to assess the degree of concordance between the two groups. Materials and methods: A cross-sectional study was conducted on 197 cases of colorectal adenocarcinoma with regional lymph node metastasis resected at the University Medical Center Ho Chi Minh City from January to December 2023. SATB2 expression was assessed on tissue microarrays (TMAs) using a semiquantitative scoring system, and independently reviewed by two pathologists. Results: SATB2 was positive in 181/197 (91.9%) primary tumors and 185/197 (93.9%) lymph node metastases. Concordance between primary tumors and metastases was observed in 185/197 cases (93.9%). Discordance was found in 12/197 cases (6.1%), including 4 cases with positive primary tumors but negative lymph nodes, and 8 cases with the opposite pattern (p < 0.001). Conclusion: SATB2 shows a high positive expression rate and strong concordance between primary colorectal adenocarcinomas and their lymph node metastases, highlighting its value in confirming colorectal origin in metastatic settings.
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Keywords
SATB2; colorectal adenocarcinoma; lymph node metastasis; immunohistochemistry.
References
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6. Montiel DP, Angulo KA, Cantú-de León D, Quevedo LB, Vilchis JC, Montalvo LH. The value of SATB2 in the differential diagnosis of intestinal-type mucinous tumors of the ovary: primary vs metastatic. Annals of diagnostic pathology. 2015;19(4):249-52.
7. Wang S, Zhou J, Wang XY, Hao JM, Chen JZ, Zhang XM, et al. Down‐regulated expression of SATB2 is associated with metastasis and poor prognosis in colorectal cancer. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland. 2009;219(1):114-22.
2. Elnady MS, Eltatawy FA, Nosseir AG, Zamzam YA, El-Guindya DM. Diagnostic accuracy of SATB2 in identifying primary and metastatic colorectal carcinoma: a comparative immunohistochemical study. ecancermedicalscience. 2022;16:1491.
3. Kim CJ, Baruch-Oren T, Lin F, Fan XS, Yang XJ, Wang HL. Value of SATB2 immunostaining in the distinction between small intestinal and colorectal adenocarcinomas. Journal of clinical pathology. 2016;69(12):1046-50.
4. Magnusson K, De Wit M, Brennan DJ, Johnson LB, McGee SF, Lundberg E, et al. SATB2 in combination with cytokeratin 20 identifies over 95% of all colorectal carcinomas. The American journal of surgical pathology. 2011;35(7):937-48.
5. Moh M, Krings G, Ates D, Aysal A, Kim GE, Rabban JT. SATB2 expression distinguishes ovarian metastases of colorectal and appendiceal origin from primary ovarian tumors of mucinous or endometrioid type. The American journal of surgical pathology. 2016;40(3):419-32.
6. Montiel DP, Angulo KA, Cantú-de León D, Quevedo LB, Vilchis JC, Montalvo LH. The value of SATB2 in the differential diagnosis of intestinal-type mucinous tumors of the ovary: primary vs metastatic. Annals of diagnostic pathology. 2015;19(4):249-52.
7. Wang S, Zhou J, Wang XY, Hao JM, Chen JZ, Zhang XM, et al. Down‐regulated expression of SATB2 is associated with metastasis and poor prognosis in colorectal cancer. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland. 2009;219(1):114-22.