title: B cell chronic lymphocytic leukaemia/small lymphocytic lymphoma: role of ZAP70 determination on bone marrow biopsy specimens.
abstract: BACKGROUND
  The course of chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) partly depends on the mutational status of the variable region of immunoglobulin heavy chain genes (IgV(H)), which defines two subgroups of tumours: mutated and unmutated. The expression of zeta-associated protein 70 (ZAP70) is significantly associated with the more aggressive unmutated forms.
  
  
  OBJECTIVE
  To assess the feasibility of the ZAP70 immunohistochemical test on bone-marrow biopsy (BMB) specimens and to compare the results with those of western blotting (WB) and IgV(H) mutational status assessed on neoplastic cells from peripheral blood.
  
  
  METHODS
  26 patients with CLL/SLL detected on BMB and with known IgV(H) mutational status were selected. ZAP70 was determined by immunohistochemistry (IHC) comparing three antibodies from different sources (Upstate, Cell Signaling, Santa Cruz, California, USA) and two different methods (APAAP and EnVision(+)). In 23 cases, ZAP70 WB results were also available.
  
  
  RESULTS
  ZAP70 determination on BMB specimens turned out to be easily feasible with routine procedures with reagents from Upstate and Cell Signaling. The results were concordant with those obtained with WB and mutational status analysis in >80% of the cases with both reagents. Three of four discordant cases were mutated/ZAP70 positive, with two staining weakly for ZAP70 on both WB and IHC.
  
  
  CONCLUSIONS
  The study confirms the role of ZAP70 as a possible surrogate of mutational status and emphasises its application in routine diagnostics; it discloses a small subset of discordant cases (mutated/ZAP70 weakly positive) that clinically cluster with the more favourable forms.
authors.affiliation: Haemolymphopathology Service, St Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Sabattini
authors.forename: Rocio
authors.initials: R
authors.lastname: Orduz
authors.forename: Cristina
authors.initials: C
authors.lastname: Campidelli
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Callea
authors.forename: Simona
authors.initials: S
authors.lastname: Zupo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cutrona
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
authors.forename: Manlio
authors.initials: M
authors.lastname: Ferrarini
authors.forename: Stefano
authors.initials: S
authors.lastname: Pileri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D001706:Biopsy; D015153:Blotting, Western; D001853:Bone Marrow / Q000201:enzymology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000097:blood / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D051746:ZAP-70 Protein-Tyrosine Kinase