{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:05:33Z","timestamp":1791353133117,"version":"4.3.1"},"reference-count":28,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2015,2,5]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Chronic lymphocytic B cell leukaemia (CLL)\/small lymphocytic B cell lymphoma (SLL) has proven to be not a uniform entity but to consist of various disease subtypes. CLL might also pose diagnostic challenges by demonstrating an uncommon immunohistochemical profile. Recently, the role of lymphocyte enhancer-binding factor 1 (LEF1) in CLL was elucidated being highly expressed and seeming to have a prognostic value. Our aim was to test the applicability of LEF1 as marker for CLL in a diagnostic setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We investigated LEF1 expression in lymphomas by immunohistochemistry on tissue microarrays containing several lymphoma entities (altogether 720 cases, including 61 CLL cases). We also separated CLL cases by zeta-chain-associated protein kinase 70 (ZAP70) and CD38 stainings and fluorescence in situ hybridisation analyses for <jats:italic>TP53<\/jats:italic> deletions and trisomy 12 into respective groups and correlated data with LEF1 expression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The area under the receiver operating characteristic curve for LEF1 as a diagnostic marker for CLL was 0.815 (95% CI 0.742 to 0.888). The relevant diagnostic cut-off value for LEF1 positivity determined by the Youden's index was 10% (specificity 92%, sensitivity 70%). The majority of CLL cases (70%) expressed LEF1. Eighteen per cent of (transformed) diffuse large B cell lymphoma cases also expressed LEF1. In most other lymphoma entities, LEF1 was negative. There was a positive correlation of LEF1 staining with ZAP70 expression (Spearman's rho: 0.438, p&lt;0.001), but not with CD38 expression, <jats:italic>TP53<\/jats:italic> deletions or trisomy 12.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LEF1 is a useful marker in the differential diagnosis of CLL in difficult cases. It shows a high specificity (92%) and a reasonable sensitivity (70%) for this entity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2015-202862","type":"journal-article","created":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T08:03:16Z","timestamp":1424937796000},"page":"473-478","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["LEF1: a highly specific marker for the diagnosis of chronic lymphocytic B cell leukaemia\/small lymphocytic B cell lymphoma"],"prefix":"10.1136","volume":"68","author":[{"given":"Thomas","family":"Menter","sequence":"first","affiliation":[{"name":"Institute of Pathology, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Dirnhofer","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandar","family":"Tzankov","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,2,24]]},"reference":[{"key":"2025092503293166000_68.6.473.1","unstructured":"M\u00fcller-Hermelink HK , Montserrat E , Catovsky D , et al . Chronic lymphocytic leukemia\/ small lymphocytic lymphoma. In: Swerdlow SH , Campo E , Harris NL , et al., eds. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC, 2008:180\u20132."},{"key":"2025092503293166000_68.6.473.2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/nrc2764","article-title":"From pathogenesis to treatment of chronic lymphocytic leukaemia","volume":"10","author":"Zenz","year":"2010","journal-title":"Nat Rev Cancer"},{"key":"2025092503293166000_68.6.473.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012283432602"},{"key":"2025092503293166000_68.6.473.4","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1182\/blood.V46.2.219.219","article-title":"Clinical staging of chronic lymphocytic leukemia","volume":"46","author":"Rai","year":"1975","journal-title":"Blood"},{"key":"2025092503293166000_68.6.473.5","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2013.783913"},{"key":"2025092503293166000_68.6.473.6","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1182\/blood.V94.6.1840","article-title":"Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia","volume":"94","author":"Damle","year":"1999","journal-title":"Blood"},{"key":"2025092503293166000_68.6.473.7","doi-asserted-by":"publisher","DOI":"10.1084\/jem.194.11.1639"},{"key":"2025092503293166000_68.6.473.8","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-02-486209"},{"key":"2025092503293166000_68.6.473.9","first-page":"1640","article-title":"The immunological profile of B-cell disorders and proposal of a scoring system for the diagnosis of CLL","volume":"8","author":"Matutes","year":"1994","journal-title":"Leukemia"},{"key":"2025092503293166000_68.6.473.10","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/ajcp\/108.4.378","article-title":"Improvement of the chronic lymphocytic leukemia scoring system with the monoclonal antibody SN8 (CD79b)","volume":"108","author":"Moreau","year":"1997","journal-title":"Am J Clin Pathol"},{"key":"2025092503293166000_68.6.473.11","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP27YWLIQRAJPW"},{"key":"2025092503293166000_68.6.473.12","doi-asserted-by":"publisher","DOI":"10.1309\/3G1XDX0DVHBNVKB4"},{"key":"2025092503293166000_68.6.473.13","doi-asserted-by":"publisher","DOI":"10.1038\/nri1529"},{"key":"2025092503293166000_68.6.473.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.08.003"},{"key":"2025092503293166000_68.6.473.15","doi-asserted-by":"publisher","DOI":"10.1084\/jem.194.11.1625"},{"key":"2025092503293166000_68.6.473.16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-02-269878"},{"key":"2025092503293166000_68.6.473.17","doi-asserted-by":"publisher","DOI":"10.1593\/neo.91972"},{"key":"2025092503293166000_68.6.473.18","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.103"},{"key":"2025092503293166000_68.6.473.19","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2652"},{"key":"2025092503293166000_68.6.473.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2012.12.013"},{"key":"2025092503293166000_68.6.473.21","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0b013e3181845ef4"},{"key":"2025092503293166000_68.6.473.22","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11702"},{"key":"2025092503293166000_68.6.473.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2005.06.011"},{"key":"2025092503293166000_68.6.473.24","doi-asserted-by":"publisher","DOI":"10.3109\/10428190903370338"},{"key":"2025092503293166000_68.6.473.25","doi-asserted-by":"publisher","DOI":"10.4081\/hr.2010.e3"},{"key":"2025092503293166000_68.6.473.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05919.x"},{"key":"2025092503293166000_68.6.473.27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.1003603"},{"key":"2025092503293166000_68.6.473.28","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12119"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2015-202862","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:29:41Z","timestamp":1758796181000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2015-202862"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,24]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2015,5,18]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/jclinpath-2015-202862"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2015-202862","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,24]]}}}