Evaluation of the polymerase chain reaction–based T-cell receptor ? clonality test in the diagnosis of early mycosis fungoides - 10/10/20
Abstract |
Background |
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.
Objective |
To evaluate the role of TCR-β assay in the diagnosis of early MF.
Methods |
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.
Results |
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).
Limitations |
This was a retrospective, relatively small study.
Conclusion |
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
Plan
Drs Baum and Barzilai contributed equally to this article. |
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Funding sources: None. |
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Conflicts of interest: None disclosed. |
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IRB approval status: Reviewed and approved by the IRB of Sheba Medical Center. |
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Reprints available from the authors. |
Vol 83 - N° 5
P. 1400-1405 - novembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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