{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:55:31Z","timestamp":1761630931282,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["08062719"],"award-info":[{"award-number":["08062719"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Special AT-rich sequence-binding protein 2 (SATB2) is a transcription factor expressed by colonic cryptic epithelium and epithelial neoplasms of the lower gastrointestinal (GI) tract, as well as by small bowel adenocarcinomas (SBAs), though at a lower rate. Nevertheless, up to now, only small SBA series, often including a very limited number of Crohn\u2019s disease-associated SBAs (CrD-SBAs) and celiac disease-associated SBAs (CD-SBA), have been investigated for SATB2 expression. We evaluated the expression of SATB2 and other GI phenotypic markers (cytokeratin (CK) 7 and CK20, caudal type homeobox 2 (CDX2) and alpha-methylacyl-CoA racemase (AMACR)), as well as mismatch repair (MMR) proteins, in 100 SBAs, encompassing 34 CrD-SBAs, 28 CD-SBAs and 38 sporadic cases (Spo-SBAs). Any mutual association and correlation with other clinico-pathologic features, including patient prognosis, were searched. Twenty (20%) SATB2-positive SBAs (4 CrD-SBAs, 7 CD-SBAs and 9 Spo-SBAs) were identified. The prevalence of SATB2 positivity was lower in CrD-SBA (12%) in comparison with both CD-SBAs (25%) and Spo-SBAs (24%). Interestingly, six SBAs (two CD-SBAs and four Spo-SBAs) displayed a full colorectal carcinoma (CRC)-like immunoprofile (CK7\u2212\/CK20+\/CDX2+\/AMACR+\/SATB2+); none of them was a CrD-SBA. No association between SATB2 expression and MMR status was observed. Although SATB2-positive SBA patients showed a more favorable outcome in comparison with SATB2-negative ones, the difference did not reach statistical significance. When cancers were stratified according to CK7\/CK20 expression patterns, we found that CK7\u2212\/CK20- SBAs were enriched with MMR-deficient cases (71%) and patients with CK7\u2212\/CK20\u2212 or CK7\u2212\/CK20+ SBAs had a significantly better survival rate compared to those with CK7+\/CK20\u2212 or CK7+\/CK20+ cancers (p = 0.002). To conclude, we identified a small (6%) subset of SBAs featuring a full CRC-like immunoprofile, representing a potential diagnostic pitfall in attempts to identify the site of origin of neoplasms of unknown primary site. In contrast with data on colorectal carcinoma, SATB2 expression is not associated with MMR status in SBAs. CK patterns influence patient survival, as CK7\u2212\/CK20\u2212 cancers show better prognosis, a behavior possibly due to the high rate of MMR-deficient SBAs within this subgroup.<\/jats:p>","DOI":"10.3390\/cancers12113441","type":"journal-article","created":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T10:46:26Z","timestamp":1605782786000},"page":"3441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Small Bowel Adenocarcinomas Featuring Special AT-Rich Sequence-Binding Protein 2 (SATB2) Expression and a Colorectal Cancer-Like Immunophenotype: A Potential Diagnostic Pitfall"],"prefix":"10.3390","volume":"12","author":[{"given":"Giuseppe","family":"Neri","sequence":"first","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Arpa","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Guerini","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Grillo","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Surgical and Diagnostic Sciences, University of Genoa and Ospedale Policlinico San Martino University Hospital, 16132 Genoa, Liguria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Vincenzo","family":"Lenti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7164-2439","authenticated-orcid":false,"given":"Paolo","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Furlan","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Sessa","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9099-5352","authenticated-orcid":false,"given":"Erica","family":"Quaquarini","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, IRCCS ICS Maugeri and Experimental Medicine School, University of Pavia, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7709-6210","authenticated-orcid":false,"given":"Alessandra","family":"Viglio","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Ubezio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Pasini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Division of Pathology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Sampietro","sequence":"additional","affiliation":[{"name":"ASST Rhodense, Rho Hospital, 20017 Rho, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Ardizzone","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Luigi Sacco University Hospital, 20157 Milan, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-5711","authenticated-orcid":false,"given":"Giovanni","family":"Latella","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Life and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Abruzzo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Mescoli","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Medicine DIMED, University of Padua, 35121 Padova, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0679-0563","authenticated-orcid":false,"given":"Massimo","family":"Rugge","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Medicine DIMED, University of Padua, 35121 Padova, Veneto, Italy"},{"name":"Veneto Tumor Registry, 35121 Padova, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-1502","authenticated-orcid":false,"given":"Fabiana","family":"Zingone","sequence":"additional","affiliation":[{"name":"Gastroenterology Section, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7086-1920","authenticated-orcid":false,"given":"Valeria","family":"Barresi","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, 37126 Verona, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-7576","authenticated-orcid":false,"given":"Rachele","family":"Ciccocioppo","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of 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Rossi, University of Verona, 37134 Verona, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-7160","authenticated-orcid":false,"given":"Paolo","family":"Pedrazzoli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"},{"name":"Oncology Unit, IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gino Roberto","family":"Corazza","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ombretta","family":"Luinetti","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Solcia","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Paulli","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0302-8645","authenticated-orcid":false,"given":"Antonio","family":"Di Sabatino","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2976-7032","authenticated-orcid":false,"given":"Alessandro","family":"Vanoli","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"ref_1","unstructured":"Adsay, N.V., Nagtegaal, I.D., and Reid, M.D. (2019). 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