title: SATB2 in combination with cytokeratin 20 identifies over 95% of all colorectal carcinomas.
abstract: The special AT-rich sequence-binding protein 2 (SATB2), a nuclear matrix-associated transcription factor and epigenetic regulator, was identified as a tissue type-specific protein when screening protein expression patterns in human normal and cancer tissues using an antibody-based proteomics approach. In this respect, the SATB2 protein shows a selective pattern of expression and, within cells of epithelial lineages, SATB2 expression is restricted to glandular cells lining the lower gastrointestinal tract. The expression of SATB2 protein is primarily preserved in cancer cells of colorectal origin, indicating that SATB2 could function as a clinically useful diagnostic marker to distinguish colorectal cancer (CRC) from other types of cancer. The aim of this study was to further explore and validate the specific expression pattern of SATB2 as a clinical biomarker and to compare SATB2 with the well-known cytokeratin 20 (CK20). Immunohistochemistry was used to analyze the extent of SATB2 expression in tissue microarrays with tumors from 9 independent cohorts of patients with primary and metastatic CRCs (n=1882). Our results show that SATB2 is a sensitive and highly specific marker for CRC with distinct positivity in 85% of all CRCs, and that SATB2 and/or CK20 was positive in 97% of CRCs. In conclusion, the specific expression of SATB2 in a large majority of CRCs suggests that SATB2 can be used as an important complementary tool for the differential diagnosis of carcinoma of unknown primary origin.
authors.affiliation: Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Magnusson
authors.forename: Meike
authors.initials: M
authors.lastname: de Wit
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Brennan
authors.forename: Louis B
authors.initials: LB
authors.lastname: Johnson
authors.forename: Sharon F
authors.initials: SF
authors.lastname: McGee
authors.forename: Emma
authors.initials: E
authors.lastname: Lundberg
authors.forename: Kirsha
authors.initials: K
authors.lastname: Naicker
authors.forename: Rut
authors.initials: R
authors.lastname: Klinger
authors.forename: Caroline
authors.initials: C
authors.lastname: Kampf
authors.forename: Anna
authors.initials: A
authors.lastname: Asplund
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wester
authors.forename: Marcus
authors.initials: M
authors.lastname: Gry
authors.forename: Anders
authors.initials: A
authors.lastname: Bjartell
authors.forename: William M
authors.initials: WM
authors.lastname: Gallagher
authors.forename: Elton
authors.initials: E
authors.lastname: Rexhepaj
authors.forename: Sami
authors.initials: S
authors.lastname: Kilpinen
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Kallioniemi
authors.forename: Eric
authors.initials: E
authors.lastname: Belt
authors.forename: Jeroen
authors.initials: J
authors.lastname: Goos
authors.forename: Gerrit
authors.initials: G
authors.lastname: Meijer
authors.forename: Helgi
authors.initials: H
authors.lastname: Birgisson
authors.forename: Bengt
authors.initials: B
authors.lastname: Glimelius
authors.forename: Carl A K
authors.initials: CA
authors.lastname: Borrebaeck
authors.forename: Sanjay
authors.initials: S
authors.lastname: Navani
authors.forename: Mathias
authors.initials: M
authors.lastname: Uhlén
authors.forename: Darran P
authors.initials: DP
authors.lastname: O'Connor
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
authors.forename: Fredrik
authors.initials: F
authors.lastname: Pontén
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000556:secondary; D000236:Adenoma; D014408:Biomarkers, Tumor / Q000378:metabolism; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry / Q000379:methods; D053554:Keratin-20 / Q000378:metabolism*; D008297:Male; D036961:Matrix Attachment Region Binding Proteins / Q000378:metabolism*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D046888:Tissue Array Analysis; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D053554:Keratin-20; D036961:Matrix Attachment Region Binding Proteins; C521297:SATB2 protein, human; D014157:Transcription Factors