Chen X, Rui W W, Bi K, Wu Y J, Zhang S X, Zhang L, Yu J, Xiu B, Yi X H, Zeng Y
Department of Pathology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200010, China.
Zhonghua Bing Li Xue Za Zhi. 2021 Mar 8;50(3):207-212. doi: 10.3760/cma.j.cn112151-20200513-00379.
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. 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. 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 (=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. 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.
评估淋巴细胞淋巴瘤/急性淋巴细胞白血病（LBL/ALL）和小B细胞淋巴瘤中LEF1蛋白的表达情况及其在LBL/ALL病理诊断和鉴别诊断中的价值。2012年1月至2019年12月在上海同济大学附属同济医院收集53例LBL/ALL病例。采用免疫组织化学方法检测53例LBL/ALL石蜡包埋组织样本中LEF1和TdT的蛋白表达。比较LEF1和TdT在LBL/ALL诊断中的特异性和敏感性。研究LEF1蛋白在77例小B细胞淋巴瘤中的表达，包括慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL）、滤泡性淋巴瘤、套细胞淋巴瘤、边缘区淋巴瘤和华氏巨球蛋白血症/淋巴浆细胞淋巴瘤。通过单因素分析评估LEF1表达与总生存期（OS）和无进展生存期（PFS）之间的相关性。LBL/ALL中LEF1的表达率为100%（53/53），中位数为90%；TdT的表达率为84.9%（T-LBL/ALL为78.1%，B-LBL/ALL为95.2%），中位数为80%；LEF1和TdT的表达率及中位数差异均有统计学意义（分别为P=0.008和P=0.001）。CLL/SLL中LEF1的表达为14/18，中位数为45%；滤泡性淋巴瘤（0/16）、套细胞淋巴瘤（0/16）、边缘区淋巴瘤（0/19）和华氏巨球蛋白血症/淋巴浆细胞淋巴瘤（0/8）中LEF1均不表达。B-LBL/ALL与小B细胞淋巴瘤之间LEF1表达差异有统计学意义。该组LBL/ALL病例的中位随访时间为16个月。LBL/ALL患者中LEF1表达与OS和PFS之间无统计学差异。LEF1免疫组织化学染色在LBL/ALL诊断中具有高敏感性和良好的特异性，其与TdT联合应用可提高LBL/ALL的诊断率。
