Journal of the American Academy of Dermatology · 2020
Evaluation of the polymerase chain reaction-based T-cell receptor β clonality test in the diagnosis of early mycosis fungoides.
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Schachter Orit, Tabibian-Keissar Hila, Debby Assaf, Segal Oz, Baum Sharon, Barzilai Aviv
Аннотация
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.
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.