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Published on: October 19, 2014
[A study of LEF1 protein expression in diagnosis and differential diagnosis of lymphoblastic lymphoma/acute
1Department of Pathology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
Insights
LEF1 protein is highly expressed in lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL), aiding its diagnosis. Combining LEF1 with TdT improves diagnostic accuracy for LBL/ALL.
Area of Science:
- Hematology
- Oncology
- Immunohistochemistry
Background:
- Lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) requires accurate diagnosis.
- Distinguishing LBL/ALL from small B-cell lymphomas is crucial for treatment.
- LEF1 protein's role in these lymphomas is not fully understood.
Purpose of the Study:
- To evaluate LEF1 protein expression in LBL/ALL and small B-cell lymphomas.
- To assess the diagnostic value of LEF1 in differentiating LBL/ALL.
- To investigate the correlation between LEF1 expression and patient survival.
Main Methods:
- Immunohistochemistry was used to detect LEF1 and TdT protein expression in 53 LBL/ALL cases and 77 small B-cell lymphoma cases.
- LEF1 expression was analyzed in various small B-cell lymphomas including CLL/SLL, follicular lymphoma, mantle cell lymphoma, marginal zone lymphoma, and Waldenstrom's macroglobulinemia.
- Statistical analysis compared LEF1 and TdT expression and correlated LEF1 with overall survival (OS) and progression-free survival (PFS).
Main Results:
- LEF1 was expressed in 100% of LBL/ALL cases, with a median value of 90%.
- TdT expression was observed in 84.9% of LBL/ALL cases.
- LEF1 showed significantly higher expression in LBL/ALL compared to small B-cell lymphomas, which lacked LEF1 expression except for some CLL/SLL cases.
Conclusions:
- Immunohistochemical staining for LEF1 demonstrates high sensitivity and specificity for diagnosing LBL/ALL.
- Combining LEF1 and TdT detection enhances the diagnostic rate of LBL/ALL.
- LEF1 expression did not show a statistically significant correlation with OS or PFS in LBL/ALL patients.
Abstract:
Objective: To evaluate the expression of LEF1 protein in lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) and small B-cell lymphomas, and its value in pathologic diagnosis and differential diagnosis of LBL/ALL. Methods: 53 cases of LBL/ALL were collected at shanghai Tongji Hospital from January 2012 to December 2019. The protein expression of LEF1 and TdT was detected by immunohistochemistry in 53 paraffin-embedded tissue samples of LBL/ALL. The specificity and sensitivity of LEF1 and TdT in the diagnosis of LBL/ALL were compared. The expression of LEF1 protein in 77 cases of small B-cell lymphomas including chronic lymphocytic leukemia/small lymphoid lymphoma (CLL/SLL), follicular lymphoma, mantle cell lymphoma, marginal zone lymphoma and Waldenstrom's macroglobulinemia/lymphoplasmacytic lymphoma was studied. The correlation between LEF1 expression and overall survival (OS) and progression-free survival (PFS) was performed by univariate analysis. Results: The expression of LEF1 in LBL/ALL was 100% (53/53), the median value was 90%; the expression of TdT was 84.9% (T-LBL/ALL 78.1%, B-LBL/ALL 95.2%), the median value was 80%; the expression rate and median value of LEF1 and TdT were significantly different (P=0.008 and 0.001 respectively). The expression of LEF1 in CLL/SLL was 14/18, the median value was 45%; LEF1 was not expressed in follicular lymphoma (0/16), mantle cell lymphoma (0/16), marginal zone lymphoma (0/19), and Waldenstrom's macroglobulinemia/lymphoplasmacytic lymphoma (0/8). LEF1 expression was significantly different between B-LBL/ALL and small B-cell lymphomas. The median follow-up time of LBL/ALL cases in this group was 16 months. There was no statistical difference between LEF1 expression and the OS and PFS in LBL/ALL patients. Conclusions: Immunohistochemical staining of LEF1 has high sensitivity and good specificity in the diagnosis of LBL/ALL, and its combination with TdT can improve the diagnostic rate of LBL/ALL.
