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Early TCR-beta and TCR-gamma PCR detection of T-cell clonality indicates minimal tumor disease in lymph nodes of cutaneous T-cell lymphoma: diagnostic and prognostic implications.
- Source :
-
Blood [Blood] 2005 Jan 15; Vol. 105 (2), pp. 503-10. Date of Electronic Publication: 2004 Sep 30. - Publication Year :
- 2005
-
Abstract
- The lymph nodes are generally the first extracutaneous manifestation in patients with cutaneous T-cell lymphoma (CTCL); however, their early involvement is difficult to assess. The aim of our study was to define the diagnostic and prognostic value of T-cell clonality analysis for a more precise assessment of lymph node involvement in CTCL. T-cell clonality was determined by 2 independent polymerase chain reaction (PCR) assays, namely a recently developed T-cell receptor-beta (TCR-beta) PCR technique as well as an established TCR-gamma PCR. T-cell clonality was found in 22 of 22 lymph nodes with histologically detectable CTCL involvement as well as in 7 of 14 histologically noninvolved dermatopathic lymph nodes. The clonal T-cell populations in the lymph nodes were in all cases identical to those detected in the corresponding skin lesions, identifying them as the tumor cell population. T-cell clonality was not found in any of the 12 dermatopathic lymph nodes from 12 patients with inflammatory skin diseases. Clonal T-cell detection in 7 of 14 dermatopathic lymph nodes of patients with CTCL was associated with limited survival (74 months; confidence interval [CI], 66-82 months) as in patients with histologically confirmed lymph node involvement (41 months; CI, 35-47 months), whereas all patients without T-cell clonality in the lymph nodes (7 patients) were alive at the last follow-up. Thus, T-cell clonality analysis is an important adjunct in differentiating benign dermatopathic lymphadenitis from early CTCL involvement.
- Subjects :
- Adult
Aged
Aged, 80 and over
Clone Cells
Female
Gene Rearrangement, beta-Chain T-Cell Antigen Receptor
Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
Humans
Lymphoma, T-Cell, Cutaneous mortality
Male
Middle Aged
Polymerase Chain Reaction
Prognosis
Skin Neoplasms mortality
Survival Rate
T-Lymphocytes pathology
T-Lymphocytes physiology
Genes, T-Cell Receptor beta
Genes, T-Cell Receptor gamma
Lymph Nodes pathology
Lymphoma, T-Cell, Cutaneous genetics
Lymphoma, T-Cell, Cutaneous pathology
Skin Neoplasms genetics
Skin Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0006-4971
- Volume :
- 105
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 15459015
- Full Text :
- https://doi.org/10.1182/blood-2004-06-2220