SATB2

SATB2 (Special AT-rich Sequence-Binding Protein 2) is a protein that plays an important role in controlling how specific genes are turned on and off. This protein helps cells grow and function normally by organizing the genetic information inside them. SATB2 is like a “manager”, ensuring specific genes work as needed.

What types of normal cells and tissue express SATB2?

SATB2 is found in several types of normal cells and tissues. It is most commonly seen in:

• The lower gastrointestinal tract: SATB2 is highly expressed in cells that line the colon and rectum, where it helps these cells function correctly.
• Bone-forming cells: SATB2 is present in osteoblasts, the cells responsible for creating new bone tissue.
• Brain tissue: SATB2 also plays a role in specific brain cells, especially during brain development.

What types of tumours express SATB2?

SATB2 expression can be found in a range of different tumour types, including:

• Tumours of the lower gastrointestinal tract: This includes adenocarcinomas, well-differentiated neuroendocrine tumours, and medullary carcinomas of the colon and rectum.
• Small intestinal adenocarcinomas: About 50% of small intestinal adenocarcinomas express SATB2.
• Bone-related tumours: Tumours with bone-forming characteristics, such as osteosarcomas and some benign bone tumours, may express SATB2.
• Soft tissue tumours: Some malignant soft tissue tumours, such as certain types of liposarcomas, may express SATB2.
• Merkel cell carcinoma: Merkel cell carcinoma is a rare but aggressive type of skin cancer, with about 79% of cases showing SATB2 positivity.

Why do pathologists test for SATB2?

Pathologists test for SATB2 to help determine where a tumour started. When a tumour is discovered, its origin is not always obvious. Knowing the primary site is crucial for choosing the proper treatment. SATB2 testing is particularly helpful in identifying tumours from the colon, rectum, or bones. By detecting SATB2, pathologists can narrow down the list of possible origins of the tumour.

How do pathologists test for SATB2?

Pathologists use a technique called immunohistochemistry (IHC) to test for SATB2 in tissue samples. IHC works by applying special antibodies to the tissue. These antibodies are designed to stick to SATB2 if it is present. When the antibodies bind to SATB2, a chemical reaction creates a colour change, making the protein visible under the microscope.

The results for SATB2 are typically described as “positive” or “negative” in a pathology report.

• SATB2-positive: This means the tumour cells produce SATB2, suggesting the tumour may have started in tissues like the colon, rectum, or bone.
• SATB2-negative: This means SATB2 was not detected, which may point to other types of tumours.

Testing for SATB2 provides important clues about a tumour’s origin, helping doctors understand its nature and plan the best treatment for the patient.