Schmitt Alessandra C, Griffith Christopher C, Cohen Cynthia, Siddiqui Momin T
Emory University School of Medicine, Pathology, Atlanta, Georgia.
Diagn Cytopathol. 2017 Dec;45(12):1078-1083. doi: 10.1002/dc.23820. Epub 2017 Oct 3.
Lymphoid enhancer binding factor 1 (LEF-1) has recently been reported as a potential immunohistochemical (IHC) marker for basal cell adenoma (BCA) and other salivary gland tumors, which may contribute to an increased accuracy in differentiating basaloid salivary gland neoplasms. We evaluated the utility of LEF-1 in fine needle aspiration (FNA) and resection specimens to distinguish pleomorphic adenoma (PA), BCA, basal cell adenocarcinoma (BCAC), and adenoid cystic carcinoma (ACC) as well as in non-neoplastic salivary gland (NNSG).
Cases including 66 PA (35 FNA, 31 resections), 12 BCA (5 FNA, 7 resections), 42 ACC (11 FNA, 31 resections), 1 BCAC FNA, and 10 NNSG (5 FNA, 5 resections) were obtained and stained for LEF-1.
On cell block (CB), 51% of PA and 60% of BCA were LEF-1 positive while 91% of ACC were LEF-1 negative. Among resections, there was a higher percentage of LEF-1 positive PA (84%) and BCA (86%), and a higher percentage of LEF-1 negative ACC (97%). LEF-1 staining had a low to moderate sensitivity for detecting benign basaloid neoplasms on FNA CB and resection specimens (52.5% and 84%, respectively), but a higher specificity (92% and 97% respectively), and positive predictive value (95% and 97% respectively).
When comparing benign (PA and BCA) and the most common malignant basaloid salivary gland tumor (ACC), positive LEF-1 favors a benign neoplasm. Additional studies with LEF-1, specifically including other rare basaloid salivary gland neoplasms are needed to further clarify the role of LEF-1 in diagnosing these lesions on FNA.
淋巴样增强子结合因子1（LEF-1）最近被报道为基底细胞腺瘤（BCA）和其他涎腺肿瘤潜在的免疫组织化学（IHC）标志物，这可能有助于提高鉴别涎腺基底样肿瘤的准确性。我们评估了LEF-1在细针穿刺（FNA）标本和手术切除标本中鉴别多形性腺瘤（PA）、BCA、基底细胞腺癌（BCAC）和腺样囊性癌（ACC）以及在非肿瘤性涎腺（NNSG）中的应用价值。
获取了包括66例PA（35例FNA，31例手术切除）、12例BCA（5例FNA，7例手术切除）、42例ACC（11例FNA，31例手术切除）、1例BCAC FNA以及10例NNSG（5例FNA，5例手术切除）的病例，并进行LEF-1染色。
在细胞块（CB）上，51%的PA和60%的BCA为LEF-1阳性，而91%的ACC为LEF-1阴性。在手术切除标本中，LEF-1阳性的PA（84%）和BCA（86%）比例更高，LEF-1阴性的ACC（97%）比例更高。LEF-1染色在FNA CB和手术切除标本上检测良性基底样肿瘤的敏感性较低至中等（分别为52.5%和84%），但特异性较高（分别为92%和97%），阳性预测值也较高（分别为95%和97%）。
在比较良性（PA和BCA）和最常见的恶性涎腺基底样肿瘤（ACC）时，LEF-1阳性支持良性肿瘤。需要对LEF-进行更多研究，特别是纳入其他罕见的涎腺基底样肿瘤，以进一步阐明LEF-1在FNA诊断这些病变中的作用。
