Evaluation of the polymerase chain reaction–based T-cell receptor β clonality test in the diagnosis of early mycosis fungoides

Orit Schachter, Hila Tabibian-Keissar, Assaf Debby, Oz Segal, Sharon Baum, Aviv Barzilai

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish
Pages (from-to)1400-1405
Number of pages6
JournalJournal of the American Academy of Dermatology
Volume83
Issue number5
DOIs
StatePublished - Nov 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020

Keywords

  • CTCL
  • PCR
  • T-cell receptor
  • TCR-β
  • clonality analysis
  • mycosis fungoides

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