Loss of satb2 occurs more frequently than cdx2 loss in colorectal carcinoma and identifies particularly aggressive cancers in high‐risk subgroups

Schmitt, M., Silva, M., Konukiewitz, B., Lang, C., Steiger, K., Halfter, K., Engel, J., Jank, P., Pfarr, N., Wilhelm, D., Foersch, S., Denkert, C., Tschurtschenthaler, M., Weichert, W., Jesinghaus, M. (2021). Cancers 13.



Background: Special AT‐rich sequence‐binding protein 2 (SATB2) has emerged as an alternative immunohistochemical marker to CDX2 for colorectal differentiation. However, the distribution and prognostic relevance of SATB2 expression in colorectal carcinoma (CRC) have to be further elucidated. Methods: SATB2 expression was analysed in 1039 CRCs and correlated with clinicopathological and morphological factors, CDX2 expression as well as survival parameters within the overall cohort and in clinicopathological subgroups. Results: SATB2 loss was a strong prognosticator in univariate analyses of the overall cohort (p < 0.001 for all survival comparisons) and in numerous subcohorts including high‐risk scenarios (UICC stage III/high tumour budding). SATB2 retained its prognostic relevance in multivariate analyses of these high‐risk scenarios (e.g., UICC stage III: DSS: p = 0.007, HR: 1.95), but not in the overall cohort (DSS: p = 0.1, HR: 1.25). SATB2 loss was more frequent than CDX2 loss (22.2% vs. 10.2%, p < 0.001) and of higher prognostic relevance with only moderate overlap between SATB2/CDX2 expression groups. Conclusions:. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.