LEF-1: Diagnostic utility in distinguishing basaloid neoplasms of the salivary gland.

TitleLEF-1: Diagnostic utility in distinguishing basaloid neoplasms of the salivary gland.
Publication TypeJournal Article
Year of Publication2017
AuthorsSchmitt AC, Griffith CC, Cohen C, Siddiqui MT
JournalDiagn Cytopathol
Volume45
Issue12
Pagination1078-1083
Date Published2017 Dec
ISSN1097-0339
KeywordsAdenocarcinoma, Adenoma, Adenoma, Pleomorphic, Biomarkers, Tumor, Carcinoma, Adenoid Cystic, Humans, Lymphoid Enhancer-Binding Factor 1, Salivary Gland Neoplasms, Salivary Glands, Sensitivity and Specificity
Abstract

BACKGROUND: 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).

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

DOI10.1002/dc.23820
Alternate JournalDiagn Cytopathol
PubMed ID28972308
PubMed Central IDPMC5930010
Grant ListUL1 TR000454 / TR / NCATS NIH HHS / United States
UL1 TR002378 / TR / NCATS NIH HHS / United States
Related Faculty: 
Momin Siddiqui, M.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
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