IHC Marker-TLE1 Test
About IHC Marker-TLE1 Test
| Field | Value |
|---|---|
| Also Known As | Transducin-like enhancer of split 1, TLE-1 immunostain, TLE1 IHC |
| Sample Type | FFPE tissue block (formalin-fixed paraffin-embedded tissue) |
| Fasting Required | No |
| Report Time | 3 days |
| Recommended For | All genders and ages; primarily ordered for suspected soft tissue tumours |
| Price | Starting at ₹1,920 |
What is an IHC Marker-TLE1 Test?
The IHC marker-TLE1 test is a specialised laboratory test that detects a protein called Transducin-like enhancer of split 1 (TLE1) in tumour tissue. It is performed using a technique called immunohistochemistry, where a specific antibody is applied to a tissue sample to reveal whether this protein is present. Doctors order this test when a soft tissue tumour is suspected, particularly to investigate whether it could be synovial sarcoma, a rare type of soft tissue cancer. The test is also known as the TLE1 IHC or TLE-1 immunostain.
What Does an IHC Marker-TLE1 Test Measure?
The TLE1 test analyses a tissue sample to detect how strongly the TLE1 protein is expressed in the tumour cells. The pathologist grades the staining across tumour cell nuclei (the control centres of cells) to reach a result.
| Staining Grade | Expression Level | Proportion of Cells Stained |
|---|---|---|
| Negative (0) | No expression | Less than 5% of tumour cell nuclei stained |
| 1+ (Weak positive) | Low expression | 5 to 25% of tumour cell nuclei stained |
| 2+ (Moderate positive) | Moderate expression | 26 to 50% of tumour cell nuclei stained |
| 3+ (Strong positive) | High expression | More than 50% of tumour cell nuclei stained with strong intensity |
Grades of 2+ or 3+ are considered a positive result and may suggest synovial sarcoma.
Why is an IHC Marker-TLE1 Test Done?
The TLE1 test procedure is used when a doctor suspects a rare soft tissue tumour and needs laboratory confirmation before deciding on further investigations.
Common Symptoms That May Require This Test
A doctor may request this test when a patient presents with the following signs:
- A noticeable lump in the soft tissue of the arms or legs
- A painless or mildly painful mass that has grown over time
- Localised swelling around a joint or soft tissue area
- Limited range of movement in a nearby joint
- Numbness or tingling if the tumour presses on a nerve
- Persistent, unexplained pain in a localised area
Conditions This Test Can Help Detect
The IHC marker-TLE1 test assists pathologists in identifying the following:
- Synovial sarcoma, a rare malignant soft tissue tumour for which TLE1 is a well-established marker
- Helps differentiate synovial sarcoma from malignant peripheral nerve sheath tumours (cancerous growths arising from nerve tissue)
- Assists in distinguishing monophasic synovial sarcoma (a single-cell-type variant) from other spindle cell tumours
- Helps separate poorly differentiated synovial sarcoma from Ewing sarcoma and related bone and soft tissue cancers
How to Prepare and What to Expect
The preparation for this test differs from a routine blood test because it requires a tissue sample obtained through a biopsy. Here is what you should know before the procedure.
Do You Need to Fast?
No fasting is required for this test. There are no dietary restrictions before the biopsy or before submitting a previously collected tissue block.
Practical Tips Before Your Test
Preparing the right documentation and samples helps ensure accurate results. Keep the following points in mind:
- Bring a detailed clinical history including your symptoms, previous test results, and any radiological reports, as this is required for the test
- Provide your original histopathology report if a biopsy has already been performed
- If a paraffin block (tissue preserved in wax) from a prior biopsy or surgery is available, send it to the laboratory
- Inform the laboratory if you have received chemotherapy or radiation therapy, as this can affect protein expression in the tissue
- Ensure the tissue sample was fixed in 10% neutral buffered formalin (a standard preservative solution)
Step-by-Step Procedure
The following steps describe the full journey from biopsy to result:
- A doctor performs a biopsy, usually an image-guided needle biopsy, to collect a small tissue sample from the suspected tumour.
- The collected tissue is immediately placed in a container with a preservative solution to keep it intact.
- In the laboratory, the tissue is processed and embedded in paraffin wax to create a solid block, known as an FFPE tissue block.
- Very thin sections of tissue are cut from the block and placed on glass slides.
- The TLE1 antibody is applied to the slide, which attaches to the TLE1 protein if present in the cells.
- A pathologist examines the stained slide under a microscope and grades the staining intensity to produce a result.
Factors That Can Affect Accuracy
Several factors can influence the quality of the staining and the final result:
- Poor tissue fixation or delays in placing the sample in preservative solution
- Prior chemotherapy or radiation therapy, which can alter protein expression
- Small or insufficient tissue sample size
- The age of the tissue block or how long it has been stored
- Technical variables in the laboratory, including antibody quality and staining protocols
Understanding Your IHC Marker-TLE1 Test Results
Results from this test should always be reviewed by a qualified pathologist alongside other clinical, radiological, and molecular findings. The table below outlines how staining grades are generally interpreted.
| Grade | Interpretation | Clinical Significance |
|---|---|---|
| Negative (0) | No TLE1 expression | Tumour is unlikely to be synovial sarcoma; negative predictive value is 96% |
| 1+ (Weak) | Low expression | Generally considered negative, synovial sarcoma less likely |
| 2+ (Moderate) | Positive | May indicate synovial sarcoma; further evaluation recommended |
| 3+ (Strong) | Strongly positive | Strongly suggestive of synovial sarcoma in the right clinical context |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
TLE1 is not entirely specific to synovial sarcoma. A positive result must be considered alongside the full clinical picture:
- Other tumours such as schwannomas and neurofibromas may also show TLE1 positivity, so a positive result alone is not conclusive.
- Previous chemotherapy or radiation therapy before biopsy collection can modify protein expression and may affect the reliability of staining.
- Inadequate tissue fixation or delays in processing can reduce staining quality and may lead to inconclusive results.
How to Maintain Healthy Levels
This test is a diagnostic tool for potential cancer and is not a wellness marker. The following are general health awareness points rather than treatment advice:
- Seek early evaluation from a specialist if you notice any persistent lump or soft tissue swelling.
- Attend all follow-up appointments as advised by your oncologist or surgeon after receiving results.
- Maintain open communication with your medical team about any new or changing symptoms.
Lupin Diagnostics IHC Marker-TLE1 Test Price
The IHC marker-TLE1 test is priced at ₹1,920 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre or the submission of a previously collected tissue block; home collection is not available for this test.
The table below provides a city-wise price guide.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 1920 |
| CHENNAI | 1920 |
| HYDERABAD | 1920 |
| KOLKATA | 1920 |
| NAVI MUMBAI | 1920 |
| PUNE | 1920 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book the TLE1 test online at Lupin Diagnostics:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample submission or tissue block drop-off.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The IHC marker-TLE1 test is used to detect TLE1 protein expression in tumour tissue, primarily to aid in the diagnosis of synovial sarcoma. It helps pathologists confirm or rule out this rare soft tissue cancer before recommending further molecular testing.
No, TLE1 is not entirely specific to synovial sarcoma. Other tumours, including schwannomas, neurofibromas, and some Ewing sarcomas, can also show TLE1 positivity. Results must always be interpreted alongside other clinical, imaging, and laboratory findings.
Published research reports a mean sensitivity of 94% and a specificity of 81% for detecting synovial sarcoma. The negative predictive value is 96%, meaning a negative result strongly suggests the tumour is not synovial sarcoma. Your pathologist will consider these figures when interpreting your result.
The test requires a formalin-fixed paraffin-embedded (FFPE) tissue block, which is a tissue sample preserved in wax. This is obtained through a biopsy or surgical procedure. If you have had a previous biopsy, the existing block can often be used.
No. Molecular testing (such as detection of a specific gene fusion) remains the definitive method for diagnosing synovial sarcoma. However, the TLE1 IHC test is faster and more cost-effective, making it a valuable first step before molecular confirmation.
At Lupin Diagnostics, the report is delivered within 3 days. Overall turnaround depends on how quickly the tissue is processed and the complexity of the staining and pathologist review.
The test requires a tissue sample, which can only be obtained through a biopsy performed by a doctor. You should consult your treating physician or oncologist first. Once a biopsy has been taken, you can submit the tissue block to a Lupin Diagnostics centre for the IHC test.
IHC Marker-TLE1 Test
