T-cell receptor (TCR) clonality may help establish a diagnosis of mycosis fungoides (MF). Routine clonality analysis is performed by using a polymerase chain reaction TCR- gamma assay, yet with this method, 10% to 50% of T-cell lymphomas escape detection. TCR- beta gene rearrangement is an additional assay. Data about its efficacy are controversial.
To evaluate the role of TCR-β assay in the diagnosis of early MF.
A retrospective study of 61 skin biopsies, 20 from patients with MF, 30 from patients suspected to have early MF, and 11 from patients with chronic inflammatory skin disease.
Monoclonality was detected in 16 of 20 (80%) MF cases: 15 (75%) with TCR-β and 12 (60%) with TCR-γ assay. Of the 30 suspected cases of early MF, 14 showed monoclonality with TCR-β, and only 5 of 14 showed monoclonality with TCR-γ assay. None of the chronic inflammatory condition samples showed monoclonality. Therefore, TCR-β clonality assay was more sensitive than TCR-γ in early MF (83% vs 43%; P = .002).
This was a retrospective, relatively small study.
TCR-β showed a higher sensitivity rate compared with TCR-γ in early-stage MF. The combined use of the TCR-β and TCR-γ clonality tests can significantly improve the diagnosis rate of early-stage MF.Le texte complet de cet article est disponible en PDF.
Key words : clonality analysis, CTCL, mycosis fungoides, PCR, T-cell receptor, TCR-β
Abbreviations used : CTCL, ISCL, MF, PCR, TCR
| Drs Baum and Barzilai contributed equally to this article.
| Funding sources: None.
| Conflicts of interest: None disclosed.
| IRB approval status: Reviewed and approved by the IRB of Sheba Medical Center.
| Reprints available from the authors.