Original ArticlesAssociation Between Loss of SATB2 Expression in Inflammatory Bowel Disease Indefinite for Dysplasia and a Diagnosis of Definitive Dysplasia on Follow-upCretara, Anthony MD*; Knee, Alexander MS†,‡; Mueller, James MD*; Jawale, Rahul MD* Author Information Departments of *Pathology †Medicine, University of Massachusetts Medical School—Baystate ‡Office of Research, Epidemiology/Biostatistics Research Core, Baystate Medical Center, Springfield, MA Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Anthony Cretara, MD, Pathology Department, University of New Mexico Hospital, 2211 Lomas Boulevard NE, Albuquerque, NM 87106 (e-mail: [email protected]). The American Journal of Surgical Pathology: August 2022 - Volume 46 - Issue 8 - p 1137-1141 doi: 10.1097/PAS.0000000000001900 Buy Metrics Abstract Special AT-rich sequence-binding protein 2 (SATB2) is a sensitive and specific biomarker for sporadic colonic adenocarcinomas. Previous studies have found that SATB2 is lost in some adenocarcinomas and dysplasias associated with inflammatory bowel disease (IBD). In establishing these findings, the prior studies did not examine cases of IBD interpreted as indefinite for dysplasia. We examined SATB2 expression in this diagnostic category to determine if any potential loss is associated with a diagnosis of definitive dysplasia on follow-up. To investigate this possibility, we collected 87 biopsies of IBD indefinite for dysplasia from 62 patients and stained them with SATB2. Among patients’ indefinite for dysplasia, we found SATB2 loss in 6/62 (9.7%). Among those with follow-up (n=51), we observed 5/6 (83%) with a future dysplasia in those with SATB2 loss compared with 10/45 (22%) in those with SATB2 retention, absolute difference 61.1% (95% confidence interval=28.9%-93.3%). We conclude that loss of SATB2 on biopsies otherwise interpreted as IBD indefinite for dysplasia may mark a population at high risk for showing definitive dysplasia on future biopsies. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.