TRBC1在成熟T细胞淋巴瘤中的表达特点及诊断价值

The expressional characteristics and diagnostic values of TRBC1 in mature T-cell lymphoma

目的分析TCRβ链恒定区结构域蛋白TRBC1在成熟T细胞淋巴瘤(TCL)中的表达特点, 并与TCRVβ分析和TCR基因重排结果比较, 探索TRBC1在TCL诊断中的价值。方法通过多参数流式细胞术(FCM)检测南京医科大学第一附属医院血液科收治的30例TCL患者(TCL组)、40名正常对照和50例无T淋巴细胞增殖性疾病患者(非TCL组)TRBC1的表达特点, 同时分析TCRVβ受体库检测、TCR基因重排与TRBC1限制性表达检测在TCL中的诊断价值。结果正常对照组CD4+T和CD8+T细胞亚群TRBC1阳性表达率分别为(39.6±6.5)%和(39.3±4.4)%, 非TCL组患者CD4+T和CD8+T细胞亚群TRBC1阳性表达率分别为(39.1±3.8)%和(36.0±8.4)%, TRBC1表达在两组中均呈双相表达模式。TCL组患者均为CD3+TCRγδ-, TRBC1阳性表达率>92.3%或<12.7%, 所有病例均呈限制性表达模式(单克隆表达), 与正常对照和非TCL组相比差异有统计学意义(P<0.001)。在T细胞克隆性检测效能方面, TRBC1灵敏性为100%, TCR基因重排阳性检出率为92.8%, TCRVβ流式试剂盒敏感性为94.1%, Kappa检验显示, 三种检测方法一致性较高。结论多参数FCM检测TRBC1表达水平能够快速高效地诊断TCL, 具有较好的临床应用价值。

Objective To investigate the expression characteristics of TRBC1 protein in mature T-cell lymphoma(TCL),and compare with T-cell receptor(TCR)-Vβrepertoire analysis and TCR gene rearrangement results,to explore the value of TRBC1 in the diagnosis of TCL.Methods The expression of TRBC1 was detected by multi-parameter flow cytometry in 30 cases of TCL,40 cases of normal controls and 50 cases of patients without T lymphocyte proliferative diseases(non-TCL)admitted to the Department of Hematology,The First Affiliated Hospital of Nanjing Medical University.The diagnostic value of TCRVβrepertoire analysis,TCR gene rearrangement and TRBC1 restricted expression detection in TCL was evaluated.Results The positive rates of CD4+T and CD8+T cell subsets TRBC1 in normal control group were(39.6±6.5)%and(39.3±4.4)%.The positive rates of CD4+T and CD8+T cell subsets TRBC1 in non-TCL were(39.1±3.8)%and(36.0±8.4)%.All 30 cases of TCL were CD3+TCRγδ-,and the positive rate of TRBC1 was>92.3%or<12.7%.All cases showed restrictive expression pattern(monoclonal expression),which was significantly different from those of the normal control and the non-TCL cases(P<0.001).In terms of the diagnostic performance of T cell clonality,the sensitivity of TRBC1 was 100%,the positive detection rate of TCR gene rearrangement was 92.8%,and the sensitivity of TCRVβdetection was 94.1%.Kappa test showed high consistency among the three detective methods.Conclusion Multi-parameter flow cytometry detection of TRBC1 expression level can quickly and efficiently diagnose mature T-cell lymphoma,which has good clinical application value.