% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Meagher:144152, author = {N. S. Meagher and L. Wang and P. F. Rambau and M. P. Intermaggio and D. G. Huntsman and L. R. Wilkens and M. A. El-Bahrawy and R. B. Ness and K. Odunsi and H. Steed and E. Herpel and M. S. Anglesio and B. Zhang and N. Lambie and A. J. Swerdlow and J. Lubiński and R. A. Vierkant and E. L. Goode and U. Menon and A. Toloczko-Grabarek and O. Oszurek and S. Bilic and A. Talhouk and M. García-Closas and Q. Wang and A. Tan and R. Farrell and C. J. Kennedy and M. Jimenez-Linan and K. Sundfeldt and J. L. Etter and J. Menkiszak and M. T. Goodman and P. Klonowski and Y. Leung and S. J. Winham and K. B. Moysich and S. Behrens$^*$ and T. Kluz and R. P. Edwards and J. Gronwald and F. Modugno and B. Y. Hernandez and C. Chow and L. E. Kelemen and G. L. Keeney and M. E. Carney and Y. Natanzon and G. Robertson and R. Sharma and S. A. Gayther and J. Alsop and H. Luk and C. Karpinskyj and I. Campbell and P. Sinn and A. Gentry-Maharaj and P. Coulson and J. Chang-Claude$^*$ and M. Shah and M. Widschwendter and K. Tang and M. J. Schoemaker and J. M. Koziak and L. S. Cook and J. D. Brenton and F. Daley and B. Kristjansdottir and C. Mateoiu and M. C. Larson and P. R. Harnett and A. Jung$^*$ and A. deFazio and K. L. Gorringe and P. D. P. Pharoah and P. Minoo and C. Stewart and O. F. Bathe and X. Gui and P. Cohen and S. J. Ramus and M. Köbel}, title = {{A} combination of the immunohistochemical markers {CK}7 and {SATB}2 is highly sensitive and specific for distinguishing primary ovarian mucinous tumors from colorectal and appendiceal metastases.}, journal = {Modern pathology}, volume = {32}, number = {12}, issn = {1530-0285}, address = {London}, publisher = {Nature Publishing Group}, reportid = {DKFZ-2019-01701}, pages = {1834-1846}, year = {2019}, note = {2019 Dec;32(12):1834-1846}, abstract = {Primary 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.}, cin = {C020}, ddc = {610}, cid = {I:(DE-He78)C020-20160331}, pnm = {313 - Cancer risk factors and prevention (POF3-313)}, pid = {G:(DE-HGF)POF3-313}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:31239549}, doi = {10.1038/s41379-019-0302-0}, url = {https://inrepo02.dkfz.de/record/144152}, }