Nuclear overexpression of lymphoid-enhancer-binding factor 1 identifies chronic lymphocytic leukemia/small lymphocytic lymphoma in small B-cell lymphomas

Mod Pathol. 2011 Nov;24(11):1433-43. doi: 10.1038/modpathol.2011.103. Epub 2011 Jun 17.

Abstract

Lymphoid-enhancer-binding factor 1 (LEF1), coupling with β-catenin, functions as a key nuclear mediator of WNT/β-catenin signaling, which regulates cell proliferation and survival. LEF1 has an important role in lymphopoiesis, and is normally expressed in T and pro-B cells but not mature B cells. However, gene expression profiling demonstrates overexpression of LEF1 in chronic lymphocytic leukemia, and knockdown of LEF1 decreases the survival of the leukemic cells. So far, the data on LEF1 expression in B-cell lymphomas are limited. This study represents the first attempt to assess LEF1 by immunohistochemistry in a large series (290 cases) of B-cell lymphomas. Strong nuclear staining of LEF1 was observed in virtually all neoplastic cells in 92 of 92 (100%) chronic lymphocytic leukemia/small lymphocytic lymphomas including two CD5- cases, with strongest staining in cells with Richter's transformation. LEF1 also highlighted the morphologically inconspicuous small lymphocytic lymphoma component in three composite lymphomas. All 53 mantle cell lymphomas, 31 low-grade follicular lymphomas and 31 marginal zone lymphomas, including 3 CD5+ cases, were negative. In 12 grade 3 follicular lymphomas, LEF1 was positive in a small subset (5-15%) of cells. Diffuse large B-cell lymphoma, however, demonstrated significant variability in LEF1 expression with overall positivity in 27 of 71 (38%) cases. Our results demonstrate that nuclear overexpression of LEF1 is highly associated with chronic lymphocytic leukemia/small lymphocytic lymphoma, and may serve as a convenient marker for differential diagnosis of small B-cell lymphomas. The expression of β-catenin, the coactivator of LEF1 in WNT signaling, was examined in 50 chronic lymphocytic leukemia/small lymphocytic lymphomas, of which 44 (88%) showed negative nuclear staining. The findings of universal nuclear overexpression of LEF1 but lack of nuclear β-catenin in the majority of chronic lymphocytic leukemia/small lymphocytic lymphoma suggest that the pro-survival function of LEF1 in this disease may be independent of WNT/β-catenin signaling.

MeSH terms

  • Biomarkers, Tumor / analysis*
  • Cell Nucleus / chemistry*
  • Chicago
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism*
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Lymphoid Enhancer-Binding Factor 1 / analysis*
  • Lymphoma, B-Cell / chemistry*
  • Lymphoma, B-Cell / pathology
  • Lymphoma, B-Cell, Marginal Zone / chemistry
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Follicular / chemistry
  • Lymphoma, Follicular / pathology
  • Lymphoma, Large B-Cell, Diffuse / chemistry
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Mantle-Cell / chemistry
  • Lymphoma, Mantle-Cell / pathology
  • Predictive Value of Tests
  • Up-Regulation
  • beta Catenin / analysis

Substances

  • Biomarkers, Tumor
  • CTNNB1 protein, human
  • LEF1 protein, human
  • Lymphoid Enhancer-Binding Factor 1
  • beta Catenin