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SATB2 Versus CDX2: A Battle Royale for Diagnostic Supremacy in Mucinous Tumors.
- Source :
-
Archives of Pathology & Laboratory Medicine . Sep2019, Vol. 143 Issue 9, p1119-1125. 7p. 3 Color Photographs, 6 Charts. - Publication Year :
- 2019
-
Abstract
- Context.-- Metastatic mucinous tumors present a diagnostic challenge for pathologists as tumor histomorphology is often nonspecific and optimal immunoprofiles are still under investigation. Objective.-- To present a head-to-head comparison of special AT-rich sequence-binding protein 2 (SATB2) and caudal type homeobox 2 (CDX2) expression in a diverse array of primary mucinous tumors. Design.-- SATB2 and CDX2 immunohistochemical stains were performed on whole sections from 44 mucinous colorectal carcinomas and 175 noncolorectal mucinous tumors. A nuclear scoring system measuring intensity (0--3+) and percentage staining (0 = <5%, 1 = 5%--49%, 2 = ≥50%) was implemented, producing an additive histologic score (H-score). Results.-- SATB2 demonstrated acceptable accuracy at low to moderate expression levels (H-scores of 1--4). With these H-score cutoffs, overall accuracy was greater than 90%. In contrast, CDX2's accuracy rivaled that of SATB2 only at an H-score of 5 (89.0%), as its specificity suffered at lower expression levels (<70.0% at H-scores of 1--4). Using a moderate H-score cutoff of 3 or higher, significant differences for both sensitivity and specificity were identified between SATB2 and CDX2 (P = .01 for sensitivity and P < .001 for specificity), though these stains were near equivalent when each was interpreted as positive at its respective optimal H-score (SATB2 ≥ 3 and CDX2 = 5). Conclusions.-- SATB2 is a more accurate marker of colorectal origin across a variety of expression levels compared with CDX2 when applied to mucinous tumors from a host of primary sites. However, these stains are near equivalent when each is interpreted at its optimal expression level. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00039985
- Volume :
- 143
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Archives of Pathology & Laboratory Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 138527749
- Full Text :
- https://doi.org/10.5858/arpa.2018-0337-OA