T-CELL RECEPTOR GENE REARRANGEMENT ANALYSIS IN THE PRIMARY CUTANEOUS T-CELL LYMPHOMA

Object: The present paper is to evaluate the significance of T cell receptor (TCR) gene rearrange ments in primary cutaneous T cell lymphomas (PCTCL) as detected by analysis of Southern Blot (SBA) and polymerase chain reaction (PCR). Patients and Methods: Skin specimens and peripheral blood samples were taken from 44 patients with PCTCL, including 30 patients with mycosis fungoides (MF), 2 patients with Sezary's syndrome (SS), and 12 patients with PCTCL other than MF and SS (PNCTCL). 11 patients with a presumptive diagnosis of MF, 23 patients with lymphoproliferative dermatoses including lymphomatoid papulosis (LyP) and 8 patients with benign cutaneous lymphoid infiltrates were simultaneously studied by the amplification of junctional V (variable) J (joining) sequences of the rearranged TCRγ genes by PCR(TCRγPCR) and the analysis of TCRb chain genes by SBA(TCRβSBA) for detection of clonal gene rearrangements (GR). One lymph node specimen of a case with MF IIA was also detected by TCRγ PCR and TCRβSBA. Results: In MF, GR were detected by TCRγPCR and TCRβSBAb in 83.3 85.7% and 66.7% 71.4% of skin specimens of cases IIA IIB and in 57.1% 70.0% and 14.3% 10.0% of those of cases IA IB, respectively. GR were seen in 66.7% 71.4% and 33.3% 43.0.% of blood samples of cases IIA IIB, and 42.9% 40.0% and 0 10.0% of those of cases IA IB, respectively. GR was confirmed by TCRγ PCR and TCRβSBA in one lymph node showing dermato pathic lymphadenopathy of a case with MF IIA. In 11 patients of clinically suspected MF, GR were present in skin specimens of 5 cases (45.4%) and in blood samples of 3 cases ( 27.3% ) by TCRγ PCR. In PNCTCL, GR were found in 9 skin specimens (90.0%) from 10 patients detected by TCRγ PCR and in 6 skin specimens (75.0%) from 8 patients detected by TCRβSBA. GR were also seen in 6 blood samples (72.8%) from 11 patients detected by TCRγ PCR, and in 7 blood samples (70.0%) from 10 patients by TCRβSBA. In SS and LyP, GR were detected by TCRγ PCR and TCRβSBA in each of the two skin specimens of two cases with LyP and in each of the two blood samples of two cases with SS. GR were seen in one skin specimen of one case with SS and one blood sample of one case with LyP detected by TCRγPCR. Conclusions: This study demonstrated that TCRγ PCR is a rapid, more sensitive tool than TCRβSBA, can be used in the analysis of T cell clonality in skin, lymph node and blood samples of patients with PCTCL and indicated that this method forms a useful supplement to other methods for diagnosis of early and suspected MF, confirmation of PNCTCL and determination of extracutaneous involvement of lymph node and blood.

T-cell receptor gene rearrangement analysis in primary cutaneous T-cell lymphoma

Objective To evaluate the significance of T-cell receptor (TCR) gene rearrangements in primary cutaneous T-cell lymphomas (PCTCL), as detected by analysis of Southern Blot (SBA) and polymerase chain reaction (PCR). Methods Skin specimens and peripheral blood samples were taken respectively from 44 patients with PCTCL [mycosis fungoides (MF), 30 patients; Sezary's syndrome (SS), 2 patients; PCTCL other than MF and SS (PNCTCL), 12 patients], 11 patients with a presumptive diagnosis of MF, 23 patients with lymphoproliferative dermatoses including lymphomatoid papulosis (LyP) and 8 patients with benign cutaneous lymphoid infiltrates. These were simultaneously studied by the amplification of junctional V (variable) J (joining) sequences of the rearranged TCRγ genes by PCR (TCRγPCR) and the analysis of TCRβ chain genes by SBA (TCRβSBA) for detection of clonal gene rearrangements (GR). One lymph node specimen of a case with MF ⅡA was also detected by TCRγPCR and TCRβSBA. Results In MF, by TCRγPCR and TCRβSBA, GR were dectected in 83.3% 85.7% and 66.7% 71.4 % of skin specimens of cases ⅡA ⅡB and 57.1% 70.0% and [WT5”BZ〗[CD26*2〗 Dermatopathologic Research Laboratory, Institute of Dermatology, Hua Shan Hospital (Qiu BS); Department of Biophysics (Gao HY, Shang YF); Department of Pathology (Xu LZ), Cancer Hospital, Shanghai Medical University, Shanghai 200040, China Nanking Railway Medical College, Nanjing 210009, China (Wang P) This project was supported by the National Natural Science Foundation of China14.3% 10.0% of those of cases IA IB, respectively. GR were seen in 66.7% 71.4 % and 33.3% 43.0% of blood samples of cases ⅡA ⅡB, and 42.9% 40.0% and 0 10% of those of cases IA IB, respectively. GR was confirmed by TCRγPCR and TCRβSBA in one lymph node showing dermatopathic lymphadenopathy of a case with MF ⅡA. In 11 patients of clinically suspected MF, GR were present in skin specimens of 5 cases (45.4%) and blood samples of 3 cases (27.3%) by TCRγPCR. In PNCTCL, GR were found in 9 skin specimens (90%) from 10 patients detected by TCRγPCR and 6 skin specimens (75%) from 8 patients detected by TCRβSBA. GR were also seen in 6 blood samples (72.8%) from 11 patients detected by TCRγPCR, and 7 blood samples (70%) from 10 patients by TCRβSBA. In SS and LyP, by TCRγPCR and TCRβSBA, GR were detected in each of the two skin specimens of two cases with LyP and each of the two blood samples of two cases with SS. GR were seen in one skin specimen of one case with SS and one blood sample of one case with LyP detected by TCRγPCR. Conclusions This study demonstrated that TCRγPCR is a rapid, more sensitive tool than TCRβSBA and can be used in the analysis of T cell clonality in skin, lymph node and blood samples of patients with PCTCL. This method forms a useful supplement to other methods for diagnosis of early and suspected MF, confirmation of PNCTCL and determination of extracutaneous involvement of lymph node and blood.