Combination of cadherin-17 and SATB homeobox 2 serves as potential optimal makers for the differential diagnosis of pulmonary enteric adenocarcinoma and metastatic colorectal adenocarcinoma

Abstract

BackgroundPulmonary enteric adenocarcinoma (PEAC), a rare type of non-small cell lung cancer, has similar histological and immunohistochemical morphology to colorectal adenocarcinoma. Cadherin-17 (CDH17) and SATB homeobox 2 (SATB2) immunoexpression have recently been demonstrated in colorectal adenocarcinoma. In this study, we evaluated the value of CDH17 and SATB2 in the diagnosis of pulmonary enteric adenocarcinoma and metastatic colorectal adenocarcinoma.MethodsA total of 13 PEAC cases and 27 metastatic colorectal adenocarcinoma cases were enrolled in our cohort study. We analyzed the expressions of CK7, CK20, CDX-2, villin, cadherin-17 (CDH17), and SATB homeobox 2 (SATB2) using immunohistochemistry. Staining intensity and percentage of positive-staining cells were recorded. Sensitivity and specificity values for immunostains, individually and in combination, were computed and compared.ResultsCombining CDH17 and SATB2 resulted in high sensitivity (76.92%) and specificity (100%). In our study, the use of CK7+, napsin A+, TTF-1+, napsin A+TTF-1+ in combination with CDH17-/SATB2- had a higher area under the curve compared to the combination CDH17-/SATB2-. However, no significant differences were observed between the combination CDH17-/SATB2- and other combinations (P>0.05).ConclusionsIn combination, CDH17 and SATB2 serve as potential optimal markers for the differential diagnosis of PEAC and metastatic colorectal adenocarcinoma.

Choroidal Mucinous Metastatic Adenocarcinoma from the Colon: A Diagnostic Challenge

“…A subset of colorectal cancers, however, loses expression of these genes [16], necessitating alternative diagnostic strategies. Moreover, although very sensitive, CDX2 and CK20, are not entirely specific for colorectal carcinomas, and may be expressed by adenocarcinomas originating from other tissues [17][18][19].…”

“…CDH17 and SATB2 are newer biomarkers that are more specific for colon cancer than CK20 and CDX2 [14,17,19,20]. CDH17 is a cell adhesion molecule that is under the transcriptional regulation of CDX2 [17,18].…”

“…CDH17 is a cell adhesion molecule that is under the transcriptional regulation of CDX2 [17,18]. Like CDX2, CDH17 is expressed throughout the whole gastrointestinal epithelium, but it is more specific than CDX2 [17,18].…”

“…CDH17 is a cell adhesion molecule that is under the transcriptional regulation of CDX2 [17,18]. Like CDX2, CDH17 is expressed throughout the whole gastrointestinal epithelium, but it is more specific than CDX2 [17,18]. SATB2 is a nuclear transcription factor whose expression is restricted to the lower gastrointestinal tract; it is considered to be the most sensitive and most specific marker for colorectal adenocarcinoma [14,17,19,20].…”

“…Like CDX2, CDH17 is expressed throughout the whole gastrointestinal epithelium, but it is more specific than CDX2 [17,18]. SATB2 is a nuclear transcription factor whose expression is restricted to the lower gastrointestinal tract; it is considered to be the most sensitive and most specific marker for colorectal adenocarcinoma [14,17,19,20]. Expression of SATB2 and CDH17 may be preserved even when expression of CK20 and CDX2 is lost [14,16].…”