The role of SATB2 as a diagnostic marker for tumors of colorectal origin: Results of a pathology-based clinical prospective study

Am J Clin Pathol. 2014 May;141(5):630-8. doi: 10.1309/AJCPWW2URZ9JKQJU.


Objectives: Immunohistochemistry is an important extension to clinical information and morphology, and prevails as an invaluable tool for establishing a correct cancer diagnosis in clinical diagnostic pathology. The applicability of immunohistochemistry is limited by the availability of validated cell- and cancer-type specific antibodies, rendering an unmet need to discover, test, and validate novel markers. The SATB2 protein is selectively expressed in glandular cells from the lower gastrointestinal tract and expression is retained in a large majority of primary and metastatic colorectal cancers.

Methods: We analyzed the expression of SATB2 in all clinical cases (n = 840), in which immunohistochemistry for detection of CK20 was deemed necessary for a final diagnosis.

Results: SATB2 showed a high sensitivity (93%) and specificity (77%) to determine a cancer of colorectal origin and in combination with CK7 and CK20, the specificity increased to 100%.

Conclusions: We conclude that SATB2 provides a new and advantageous supplement for clinical differential diagnostics.

Keywords: Cancer of unknown primary (CUP); Colorectal cancer; Cytokeratin 20; Immunohistochemistry; SATB2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology
  • Aged
  • Biomarkers, Tumor / metabolism*
  • Colorectal Neoplasms / metabolism*
  • Colorectal Neoplasms / pathology*
  • Female
  • Humans
  • Immunohistochemistry / methods
  • Keratin-20 / metabolism
  • Keratin-7 / metabolism
  • Male
  • Matrix Attachment Region Binding Proteins / metabolism*
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Transcription Factors / metabolism*


  • Biomarkers, Tumor
  • Keratin-20
  • Keratin-7
  • Matrix Attachment Region Binding Proteins
  • SATB2 protein, human
  • Transcription Factors