000144152 001__ 144152
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000144152 0247_ $$2doi$$a10.1038/s41379-019-0302-0
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000144152 1001_ $$00000-0001-9134-2118$$aMeagher, Nicola S$$b0
000144152 245__ $$aA combination of the immunohistochemical markers CK7 and SATB2 is highly sensitive and specific for distinguishing primary ovarian mucinous tumors from colorectal and appendiceal metastases.
000144152 260__ $$aLondon$$bNature Publishing Group$$c2019
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000144152 500__ $$a2019 Dec;32(12):1834-1846
000144152 520__ $$aPrimary ovarian mucinous tumors can be difficult to distinguish from metastatic gastrointestinal neoplasms by histology alone. The expected immunoprofile of a suspected metastatic lower gastrointestinal tumor is CK7-/CK20+/CDX2+/PAX8-. This study assesses the addition of a novel marker SATB2, to improve the diagnostic algorithm. A test cohort included 155 ovarian mucinous tumors (105 carcinomas and 50 borderline tumors) and 230 primary lower gastrointestinal neoplasms (123 colorectal adenocarcinomas and 107 appendiceal neoplasms). All cases were assessed for SATB2, PAX8 CK7, CK20, and CDX2 expression on tissue microarrays. Expression was scored in a 3-tier system as absent, focal (1-50% of tumor cells) and diffuse ( >50% of tumor cells) and then categorized into either absent/present or nondiffuse/diffuse. SATB2 and PAX8 expression was further evaluated in ovarian tumors from an international cohort of 2876 patients (expansion cohort, including 159 mucinous carcinomas and 46 borderline mucinous tumors). The highest accuracy of an individual marker in distinguishing lower gastrointestinal from ovarian mucinous tumors was CK7 (91.7%, nondiffuse/diffuse cut-off) followed by SATB2 (88.8%, present/absent cut-off). The most effective combination was CK7 and SATB2 with accuracy of 95.3% using the 3-tier interpretation, absent/focal/diffuse. This combination outperformed the standard clinical set of CK7, CK20 and CDX2 (87.5%). Re-evaluation of outlier cases confirmed ovarian origin for all but one case. The accuracy of SATB2 was confirmed in the expansion cohort (91.5%). SATB2 expression was also detected in 15% of ovarian endometrioid carcinoma but less than 5% of other ovarian histotypes. A simple two marker combination of CK7 and SATB2 can distinguish lower gastrointestinal from ovarian primary mucinous tumors with greater than 95% accuracy. PAX8 and CDX2 have value as second-line markers. The utility of CK20 in this setting is low and this warrants replacement of this marker with SATB2 in clinical practice.
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000144152 7001_ $$aWang, Linyuan$$b1
000144152 7001_ $$aRambau, Peter F$$b2
000144152 7001_ $$aIntermaggio, Maria P$$b3
000144152 7001_ $$aHuntsman, David G$$b4
000144152 7001_ $$aWilkens, Lynne R$$b5
000144152 7001_ $$aEl-Bahrawy, Mona A$$b6
000144152 7001_ $$aNess, Roberta B$$b7
000144152 7001_ $$aOdunsi, Kunle$$b8
000144152 7001_ $$aSteed, Helen$$b9
000144152 7001_ $$aHerpel, Esther$$b10
000144152 7001_ $$aAnglesio, Michael S$$b11
000144152 7001_ $$aZhang, Bonnie$$b12
000144152 7001_ $$aLambie, Neil$$b13
000144152 7001_ $$aSwerdlow, Anthony J$$b14
000144152 7001_ $$aLubiński, Jan$$b15
000144152 7001_ $$aVierkant, Robert A$$b16
000144152 7001_ $$aGoode, Ellen L$$b17
000144152 7001_ $$aMenon, Usha$$b18
000144152 7001_ $$aToloczko-Grabarek, Aleksandra$$b19
000144152 7001_ $$aOszurek, Oleg$$b20
000144152 7001_ $$aBilic, Sanela$$b21
000144152 7001_ $$aTalhouk, Aline$$b22
000144152 7001_ $$aGarcía-Closas, Montserrat$$b23
000144152 7001_ $$aWang, Qin$$b24
000144152 7001_ $$aTan, Adeline$$b25
000144152 7001_ $$aFarrell, Rhonda$$b26
000144152 7001_ $$aKennedy, Catherine J$$b27
000144152 7001_ $$aJimenez-Linan, Mercedes$$b28
000144152 7001_ $$aSundfeldt, Karin$$b29
000144152 7001_ $$aEtter, John L$$b30
000144152 7001_ $$aMenkiszak, Janusz$$b31
000144152 7001_ $$aGoodman, Marc T$$b32
000144152 7001_ $$aKlonowski, Paul$$b33
000144152 7001_ $$aLeung, Yee$$b34
000144152 7001_ $$aWinham, Stacey J$$b35
000144152 7001_ $$aMoysich, Kirsten B$$b36
000144152 7001_ $$0P:(DE-He78)6b04712f3afe72044d496a25505cb1ea$$aBehrens, Sabine$$b37$$udkfz
000144152 7001_ $$aKluz, Tomasz$$b38
000144152 7001_ $$aEdwards, Robert P$$b39
000144152 7001_ $$aGronwald, Jacek$$b40
000144152 7001_ $$aModugno, Francesmary$$b41
000144152 7001_ $$aHernandez, Brenda Y$$b42
000144152 7001_ $$aChow, Christine$$b43
000144152 7001_ $$aKelemen, Linda E$$b44
000144152 7001_ $$aKeeney, Gary L$$b45
000144152 7001_ $$aCarney, Michael E$$b46
000144152 7001_ $$aNatanzon, Yanina$$b47
000144152 7001_ $$aRobertson, Gregory$$b48
000144152 7001_ $$aSharma, Raghwa$$b49
000144152 7001_ $$aGayther, Simon A$$b50
000144152 7001_ $$aAlsop, Jennifer$$b51
000144152 7001_ $$aLuk, Hugh$$b52
000144152 7001_ $$aKarpinskyj, Chloe$$b53
000144152 7001_ $$aCampbell, Ian$$b54
000144152 7001_ $$aSinn, Peter$$b55
000144152 7001_ $$aGentry-Maharaj, Aleksandra$$b56
000144152 7001_ $$aCoulson, Penny$$b57
000144152 7001_ $$0P:(DE-He78)c259d6cc99edf5c7bc7ce22c7f87c253$$aChang-Claude, Jenny$$b58$$udkfz
000144152 7001_ $$aShah, Mitul$$b59
000144152 7001_ $$aWidschwendter, Martin$$b60
000144152 7001_ $$aTang, Katrina$$b61
000144152 7001_ $$aSchoemaker, Minouk J$$b62
000144152 7001_ $$aKoziak, Jennifer M$$b63
000144152 7001_ $$aCook, Linda S$$b64
000144152 7001_ $$aBrenton, James D$$b65
000144152 7001_ $$aDaley, Frances$$b66
000144152 7001_ $$aKristjansdottir, Björg$$b67
000144152 7001_ $$aMateoiu, Constantina$$b68
000144152 7001_ $$aLarson, Melissa C$$b69
000144152 7001_ $$aHarnett, Paul R$$b70
000144152 7001_ $$0P:(DE-He78)bce1fdec5ce564e2666156d96aeabec9$$aJung, Audrey$$b71$$udkfz
000144152 7001_ $$adeFazio, Anna$$b72
000144152 7001_ $$aGorringe, Kylie L$$b73
000144152 7001_ $$aPharoah, Paul D P$$b74
000144152 7001_ $$aMinoo, Parham$$b75
000144152 7001_ $$aStewart, Colin$$b76
000144152 7001_ $$aBathe, Oliver F$$b77
000144152 7001_ $$aGui, Xianyong$$b78
000144152 7001_ $$00000-0002-4860-9232$$aCohen, Paul$$b79
000144152 7001_ $$aRamus, Susan J$$b80
000144152 7001_ $$00000-0002-6615-2037$$aKöbel, Martin$$b81
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