Expression And Differential Significance Of CK7,CK20,CDX-2 And SATB2 In Ovarian Primary Mucinous Adenocarcinoma And Metastatic Colorectal Adenocarcinoma

ObjectiveTo explore the clinicopathological features of Primary ovarian mucinous adenocarcinoma(POMA)and Metastatic colorectal mucinous adenocarcinoma of the ovary(MCMAO).The meanings of expression and differential diagnosis of CK7,CK20,CDX-2 and SATB2 were detected in ovarian primary and metastatic mucinous adenocarcinoma by immunohistochemical.MethodsAll the paraffin blocks were obtained from the First Affiliated Hospital of Anhui Medical University,Department of Pathology,between 2011 and 2016.Including 26 cases of Primary ovarian mucinous adenocarcinoma,30 cases of ovarian metastatic colorectal mucinous adenocarcinoma,55 cases of colorectal mucinous adenocarcinoma,15 cases of ovarian metastatic gastric mucinous adenocarcinoma,35 cases of gastric mucinous adenocarcinoma,20 cases of mucinous cystic neoplasms of the pancreas.The expression of CK7,CK20,CDX-2 and SATB2 was detected by immunohistochemical.The clinical pathological features were analyzed.Result(1)SATB2 staining was negative in all cases of ovarian primary mucinous adenocarcinoma,ovarian metastatic gastric adenocarcinoma,gastric mucinous adenocarcinoma and mucinous cystic neoplasms of the pancreas.The expression rate of SATB2 in MCMAO and CMA was 66.7%(20/30)and 60.0%(33/55)respectively.(2)POMA is usually unilateral,and the size of tumor is greater than or equal to 10cm,which demonstrate cystic or cystic-solid growth patterns.On the contrary,MCMAO is usually bilateral,and the size of tumor is less than 10cm,which demonstrate solid growth patterns.(3)The expression of CK7 in POMA was significantly higher than that of MCMAO and CMA(P<0.05).The expression of CK20,CDX-2 and SATB2 in MCMAO and CMA were significantly higher than that of POMA(P<0.05).(4)The expression difference of CK7(+)/CK20(-),CK7(-)/CK20(+)and CK7(+)/CK20(+)in POMA and MCMAO were statistical significance(P<0.05),but there were no statistical significance in expression difference of CK20(+)/CK7(-)(P>0.05)(5)The sensitivity of CK7,CK20,CDX-2 and SATB2 were 0.833,0767,0.876 and 0.667 respectively,the specificity of CK7,CK20,CDX-2 and SATB2 were 0.808,0.615,0.654 and 1.000 respectively.(6)The combination of SATB2 and other markers have higher accuracy,and CK7/CDX-2/SATB2 was the best,with an accuracy of 85.7%.Conclusion(1)The expression of SATB2 in ovarian mucinous neoplasms suggests the origin from colorectal or appendix.SATB2 can be used as a senstive biomarker for the differential diagnosis in ovarian primary mucinous adenocarcinoma and metastatic colorectal adenocarcinoma.(2)Combined detection of CK7,CDX-2 and SATB2 can improve the accuracy of pathological diagnosis of POMA and MCMAO,and reduce the error rate.CK7(-)/CDX-2(+)/SATB2(+)highly support the origin from colorectal,CK7(+)/CDX-2(-)/SATB2(-)suggests the diagnosis of primary mucinous adenocarcinoma of the ovary.