Concomitant expression patterns of CDX2 and SATB2 as prognostic factors in stage III colorectal cancers

Ji-Ae Lee; Hye Eun Park; Hye-Yeong Jin; Lingyan Jin; Nam-Yun Cho; Jeong Mo Bae; Jung Ho Kim; Gyeong Hoon Kang

doi:10.1016/j.anndiagpath.2024.152289

Concomitant expression patterns of CDX2 and SATB2 as prognostic factors in stage III colorectal cancers

Ann Diagn Pathol. 2024 Mar 6:71:152289. doi: 10.1016/j.anndiagpath.2024.152289. Online ahead of print.

Authors

Ji-Ae Lee¹, Hye Eun Park², Hye-Yeong Jin³, Lingyan Jin³, Nam-Yun Cho⁴, Jeong Mo Bae³, Jung Ho Kim⁵, Gyeong Hoon Kang⁶

Affiliations

¹ Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
² Department of Pathology, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
³ Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁴ Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁵ Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁶ Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: ghkang@snu.ac.kr.

PMID: 38555678
DOI: 10.1016/j.anndiagpath.2024.152289

Abstract

CDX2 and SATB2 are often used as biomarkers for identification of colorectal origin in primary or metastatic adenocarcinomas. Loss of CDX2 or SATB2 expression has been associated with poor prognosis in patients with colorectal cancer (CRC). However, little is known regarding clinicopathological features, including prognosis, of CRCs with concomitant loss of CDX2 and SATB2. A total of 431 stage III CRCs were analyzed for their expression status in CDX2 and SATB2 using tissue microarray-based immunohistochemistry and expression status was correlated with clinicopathological variables, molecular alterations, and survival. CDX2-negative (CDX2-) CRCs and SATB2-negative (SATB2-) CRCs were found in 8.1 % and 17.2 % of CRCs, respectively, whereas both CDX2-negative and SATB2-negative (CDX2-/SATB2-) CRCs comprised 3.2 % of the CRCs. On survival analysis, neither CDX2-/SATB2+ nor CDX2+/SABT2- CRCs but CDX2-/SATB2- CRCs were associated with poor prognosis. CDX2-/SATB2- CRCs showed significant associations with tumor subsite of right colon, poor differentiation, decreased expression of CK20, aberrant expression of CK7, CIMP-high, MSI-high, and BRAF mutation. In summary, our results suggest that concomitant loss of CDX2 and SATB2 is a prognostic biomarker but isolated loss of CDX2 or SATB2 is not a prognostic biomarker for stage III CRCs.

Keywords: Adjuvant therapy; And SATB2; CDX2; Colorectal cancer; Pathology; Prognosis.