Value of SATB2 in the Differential Diagnosis of Intestinal-Type Mucinous Tumors of the Ovary
Delia Perez Montiel, Karen Arispe Angulo, Guadalupe Moncada, Lourdes Pena, Leticia Bornstein, Jose Chanona, David Cantu de Leon. Instituto Nacional de Cancerologia, Mexico City, Mexico; InmunoQ, Mexico City, Mexico
Background: Primary mucinous adenocarcinomas of the ovary are a diagnostic challenge since their histological and immunohistochemical features usually overlap with metastatic tumors. SATB2 is a recently identified protein with restricted expression in the glandular cells lining the lower gastrointestinal tract. The aim of this study is to further explore the differential expression of SATB2 in primary and metastatic tumors of the ovary.
Design: From the pathology files of the Instituto Nacional de Cancerología de México, mucinous ovarian tumors of intestinal type were retrieved, a double reading of H&E slides was performed in order to confirm diagnosis, detailed review of the clinical chart was performed to define the primary origin of the tumor (ovarian vs metastatic). Immunohistochemical staining for CK20, CDX2 and SATB2 were performed and evaluated by two gyneco-pathologist.
Results: Twenty-four mucinous tumors were identified; 11 were classified as metastatic according to clinical features (7 well-differentiated colon adenocarcinomas and 4 well-differentiated adenocarcinomas of the appendix), the rest were catalogued as primary neoplasms of the ovary (at least 2 years of follow-up during which there were no carcinomatosis, pseudomixomas, or tumors at other sites). The primary neoplasms of the ovary were positive to CDX2 in 38% of cases, positive to CK20 in 92%, and all were negative to SATB2. The metastatic neoplasms were positive to SATB2 in 90% of cases, positive to CDX2 in 81%, and to CK20 in 100%. Specificity SATB2 for differentiation of metastatic from primary was 96.4%, sensitivity 87.5%, PPV 95% and NPV90%, for CDx2 specificity 61,5%, sensitivity 81,8%, PPV 64% and NPV 80%, CK20 specificity 10%, sensitivity 95,8%, PPV 47,9% and NPV75%, respectively.
Conclusions: SATB2 appears to be a useful antibody in the differential diagnosis between primary and metastatic mucinous intestinal-type neoplasms, and highly sensitive in detecting lower gastrointestinal tract metastasis.
Category: Gynecologic & Obstetrics
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 154, Wednesday Morning