Đánh giá biểu hiện dấu ấn SATB2 trên u nguyên phát và hạch di căn tương ứng của carcinôm tuyến đại tràng

Colorectal adenocarcinoma (CRC) remains a global health challenge, with accurate diagnosis of metastatic lesions of unknown origin often complicated by morphological similarities to other adenocarcinomas. While conventional immunohistochemical markers like CK20 and CDX2 have limitations, SATB2 has emerged as a highly sensitive and specific marker for colorectal adenocarcinoma, proving valuable in identifying the primary origin of metastatic lesions. However, comprehensive data on the concordance of SATB2 expression between primary tumors and their corresponding lymph node metastases is scarce, particularly in the Vietnamese context. This study addresses this critical gap by evaluating SATB2 expression in primary colorectal adenocarcinomas and their regional lymph node metastases, aiming to assess the consistency of its expression across these sites.

Các bác sĩ giải phẫu bệnh, chuyên gia ung thư, và nhà nghiên cứu y học quan tâm đến chẩn đoán và tiên lượng ung thư đại trực tràng.

This cross-sectional study comprehensively evaluated the expression of SATB2, a highly sensitive and specific immunohistochemical marker, in both primary colorectal adenocarcinoma tumors and their corresponding regional lymph node metastases. The primary objective was to assess the degree of concordance of SATB2 expression between these two sites to enhance diagnostic accuracy for metastatic lesions of unknown origin. The research involved 197 cases of resected colorectal adenocarcinoma with regional lymph node metastasis from the University Medical Center Ho Chi Minh City, conducted from January to December 2023. SATB2 expression was analyzed on tissue microarrays using a semiquantitative scoring system and independently reviewed by two pathologists, with discordant cases re-evaluated using full block staining. Results demonstrated a high positive expression rate for SATB2 in both primary tumors (91.9%) and lymph node metastases (93.9%), with a remarkable concordance of 93.9% between them. A small percentage of cases (6.1%) exhibited discordance (p < 0.001), often linked to more aggressive biological behavior or tumor heterogeneity, highlighting the importance of thorough evaluation. These findings affirm SATB2's significant utility as a reliable marker for establishing the colorectal origin of metastatic lesions. The study suggests that while SATB2 is a powerful diagnostic tool, combining it with other immunohistochemical markers such as CK20 and CDX2 can further optimize diagnostic accuracy. Limitations include the sample size and the use of TMAs, indicating a need for larger, multi-center studies with whole slide evaluation to validate these findings across a broader range of histological subtypes and distant metastases, ultimately refining its role in clinical practice.