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SATB2 Expression in Uterine Sarcoma: A Multicenter Retrospective Study.

Cécile Le Page, Noorah Almadani, Gulisa Turashvili

    International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists
    |March 15, 2021
    PubMed
    Summary

    Special AT-rich sequence-binding protein 2 (SATB2) shows promise as a diagnostic marker for distinguishing endometrial stromal sarcoma (ESS) from endometrial stromal nodules. SATB2 expression may also offer prognostic value in ESS patients.

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    Area of Science:

    • Gynecologic Oncology
    • Surgical Pathology
    • Molecular Diagnostics

    Background:

    • Uterine sarcomas present diagnostic challenges and variable prognoses.
    • Accurate differentiation of subtypes like endometrial stromal sarcoma (ESS) is crucial for patient management.
    • Identifying reliable biomarkers for uterine sarcoma diagnosis and prognosis is an ongoing clinical need.

    Purpose of the Study:

    • To investigate the expression of special AT-rich sequence-binding protein 2 (SATB2) in various uterine sarcoma subtypes.
    • To assess SATB2's utility in differentiating endometrial stromal sarcoma (ESS) from endometrial stromal nodule.
    • To explore the potential prognostic significance of SATB2 in patients with ESS.

    Main Methods:

    • Immunohistochemistry was employed to evaluate SATB2 expression in tissue sections from 71 uterine tumors.
    • An expanded cohort of 78 additional uterine tumor samples was analyzed using a tissue microarray.
    • Nuclear SATB2 staining was quantified, with a cut-off of ≥10% tumor cell staining defined as positive.

    Main Results:

    • SATB2 was negative in all endometrial stromal nodule samples (n=10).
    • Positive SATB2 staining was observed in 83% of low-grade ESS (n=29/35), with lower rates in other uterine sarcomas.
    • In ESS, SATB2 expression correlated with progesterone receptor (PR) positivity and was associated with a decreased risk of disease-specific death.

    Conclusions:

    • SATB2 demonstrates relative sensitivity (83%) for distinguishing low-grade endometrial stromal sarcoma from endometrial stromal nodule.
    • SATB2 may serve as a valuable diagnostic marker in uterine pathology.
    • SATB2 expression holds potential prognostic value in endometrial stromal sarcoma patients.