{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T14:46:26Z","timestamp":1785681986855,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Differentiation between adult T-cell leukemia\/lymphoma (ATLL) and peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), is often challenging based on pathological findings alone. Although serum anti-HTLV-1 antibody positivity is required for ATLL diagnosis, this information is often not available at the time of pathological diagnosis. Therefore, we examined whether the expression of SOX4 and p16 would be helpful for differentiating the two disease entities. We immunohistochemically examined SOX4 and p16 expression (which have been implicated in ATLL carcinogenesis) in 11 ATLL patients and 20 PTCL-NOS patients and classified them into four stages according to the percentage of positive cells. Among the ATLL cases, 8\/11 (73%) were SOX4-positive, while only 2\/20 (10%) PTCL-NOS cases expressed SOX4. The mean total score was 4.2 (standard deviation (SD): 0.61) in the ATLL group and 0.50 (SD: 0.46) in the PTCL-NOS group (p &lt; 0.001). Positive expression of p16 was noted in 4\/11 (36%) patients with ATLL and 3\/20 (15%) patients with PTCL-NOS, with mean total scores of 1.9 (SD: 0.64) and 0.70 (SD: 0.48) in the ATLL and PTCL-NOS groups, respectively (p = 0.141). These results suggest that SOX4 may be strongly expressed in ATLL compared to PTCL-NOS cases. Therefore, it may be helpful to perform immunohistochemical staining of SOX4 when pathologists face challenges discriminating between ATLL and PTCL-NOS.<\/jats:p>","DOI":"10.3390\/diagnostics11050766","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T21:49:20Z","timestamp":1619300960000},"page":"766","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic Utility of SOX4 Expression in Adult T-Cell Leukemia\/Lymphoma"],"prefix":"10.3390","volume":"11","author":[{"given":"Atsuko","family":"Nasu","sequence":"first","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"},{"name":"Division of Anatomic Pathology, Okayama University Hospital, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-7914","authenticated-orcid":false,"given":"Yuka","family":"Gion","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-7501","authenticated-orcid":false,"given":"Yoshito","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Okayama University Hospital, Okayama 700-8558, Japan"},{"name":"Department of Medicine, John A. Burns School of Medicine, University of Hawai\u2019i, Honolulu, HI 96813, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1485-0527","authenticated-orcid":false,"given":"Asami","family":"Nishikori","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misa","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuria","family":"Egusa","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Fujita","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-6861","authenticated-orcid":false,"given":"Yasuharu","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan"},{"name":"Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.17116\/patol20188006143","article-title":"A revised 4 edition WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues, 2017: Myeloid neoplasms","volume":"80","author":"Kovrigina","year":"2018","journal-title":"Arkhiv Patol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11899-018-0456-8","article-title":"Updates in the Pathology of Precursor Lymphoid Neoplasms in the Revised Fourth Edition of the WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues","volume":"13","author":"Wenzinger","year":"2018","journal-title":"Curr. 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