The Expression Of Satb2 Is Associated With Clinicopathological Significance And Prognosis In Pelvic And Abdominal Mucinous Tumors

Objectives By detecting SATB2 protein in pelvic and abdominal mucinous tumors,to analyze its relationship with clinicopathological features and prognosis.To explore the value of SATB2 protein in differential diagnosis of pelvic and abdominal myxoma combined with CK7,CK20,CDX-2 and ER protein.Methods Paraffin-embedded specimens of 105 colorectal mucinous adenocarcinomas,71 appendiceal mucinous tumors and 97 ovarian mucinous tumors were collected from January 2012 to December 2018 in Tangshan Gong Ren Hospital.SATB2,CK7,CK20,CDX-2 and ER proteins were detected by immunohistochemistry Envision two-step method.The relationship between SATB2 protein and clinicopathological characteristics was analyzed by ?~2 test or Fisher's accurate test.Kaplan-Meier curve analysis was used to compare the survival differences between patients with positive SATB2 protein and patients with negative SATB2 protein in colorectal mucinous adenocarcinomas and appendiceal mucinous tumors.Sensitivity,specificity and Yoden index of SATB2,CK7,CK20,CDX-2,ER protein and proteins' combination in different tissues were calculated.Results 1 The expression of SATB2 protein in colorectal mucinous adenocarcinomas is associated with lymph-vascular space invasion,T stage,lymph node metastasis,carcinoma nodule and distant metastasis.And the positive rate of SATB2 was decreased in cases with lymph-vascular space invasion,T4 stage,lymph node metastasis,cancer node and distant metastasis(P<0.05).The positive rate of SATB2 in cases with lymph-vascular space invasion(29%)was lower than those without lymph-vascular space invasion(85.1%),and cases with T4 stage(37.5%)was lower than those with T1 stage(66.7%),T2 stage(100%)or T3 stage(75.4%).The positive rate of SATB2 in cases with lymph node metastasis(22.5%)was lower than those without lymph node metastasis(96.9%),cases with carcinoma nodule(33.3%)was lower than those without carcinoma nodule(75.9%),and cases with distant metastasis(9.1%)was lower than those without distant metastasis(75.5%).2 The expression of SATB2 in appendiceal mucinous tumors was related to gender and the positive rate in female cases(100%)was higher than male cases(86.4%,P=0.000).But it was not related to age,tumor size and histologic classification.3 The expression of SATB2 in ovarian mucinous tumors was not related to age,tumor size,tumor site and histological classification.4 In colorectal mucinous adenocarcinomas and appendiceal mucinous tumors PFS of patients with positive SATB2 was higher than those with negative SATB2(P<0.05).5 The positive rate of SATB2 in colorectal mucinous adenocarcinomas(68.6%)was lower than that in normal mucosa(83.8%,P=0.002).The positive rates of CK7,CK20 and CDX-2 in mucinous adenocarcinoma were 10.5%,94.3%and 93.3%,respectively.ER protein was negative in normal mucosa and mucinous adenocarcinoma.There was no difference in expression of SATB2,CK7,CK20,CDX-2and ER in histological classification of appendiceal mucinous tumors.The expression of CK7 and CK20 protein in histological classification of ovarian mucinous tumors was different(P<0.05),but no difference in expression of SATB2,CDX-2 and ER protein.6To determine primary site of colorectum individual protein and proteins' combination are as follows: SATB2(+)(sensitivity 68.6%,specificity 95.9%),CDX-2(+)&CK7(-)(sensitivity 84.8%,specificity 91.8%),SATB2(+)& CK20(+)&CK7(-)(sensitivity 57.1%,specificity 100%),SATB2(+)&CK20(+)&CDX-2(+)&CK7(-)(sensitivity 43.7%,specificity 100%).To determine primary site of appendix the protein and proteins' combination are as follows: SATB2(+)(sensitivity 90.1%,specificity 95.9%),SATB2(+)&CK7(-)(sensitivity 69%,specificity 99%),SATB2(+)&CDX-2(+)&CK7(-)(sensitivity 67.6%,specificity 100%),SATB2(+)&CK20(+)&CDX-2(+)&CK7(-)(sensitivity 43.7%,specificity 100%).To determine primary site of ovary the protein and proteins' combination are as follows: CK7(+)(sensitivity 90.7%,specificity 89.5%),CK7(+)&SATB2(-)(sensitivity 87.6%,specificity 97.1%),CK7(+)&SATB2(-)&CK20/CDX-2(-)(sensitivity 44.3%,specificity 100%),CK7(+)&SATB2(-)&CK20(-)&CDX-2(-)(sensitivity 27.8%,specificity 100%).Conclusions 1 The expression of SATB2 protein may be related to the invasion of colorectal mucinous adenocarcinomas.The lower the positive rate of SATB2,the higher the invasion of colorectal mucinous adenocarcinoma.2 In colorectal mucinous adenocarcinomas and appendiceal mucinous tumors,the PFS of cases with positive SATB2 is higher than those with negative SATB2.SATB2 may be related to prognosis of colorectal mucinous adenocarcinomas and appendiceal mucinous tumors.3 SATB2 protein can be used to differentiate pelvic and abdominal mucinous tumors by combining CK7,CK20 and CDX-2 proteins,which is of great value in judging primary site of pelvic and abdominal mucinous tumors.Figure14;Table10;Reference 107...