The Value of PCR Detection of TCR gamma Gene Rearrangement in the Diagnosis of Early Mycosis Fungoides / 대한피부과학회지

BACKGROUND: The diagnosis and differential diagnosis of mycosis fungoides(MF) is often difficult, clinically and histologically. A variety of inflammatory dermatoses may be seen with similar clinical and histological features. Given the limitation of histologic diagnosis in the early MF, an ancillary method to demonstrate a clonal T cell proliferation would be helpful. Recent attempts to enhance diagnostic sensitivity have involved T-cell receptor(TCR) gene rearrangement studies, using polymerase chain reaction(PCR) technique. OBJECTIVE: The purpose of this study was the value of PCR detection of TCR gamma gene rearrangement in the diagnosis of early MF. MATERIALS AND METHODS: Thirty-two cases of paraffin embedded tissue(PET) from patients of early MF were investigated for the presence of TCR gamma gene rearrangement using a nested PCR technique and analyzed by polyacrylamide gel electrophoresis(PAGE). As a control, PET from patients of 6 psoriasis, 3 lichen planus, 1 neurodermatitis, and 1 allergic contact dermatitis were tested. RESULTS: Monoclonal TCR gamma gene rearrangement was detected in 28 out of 32 (88%) patients with early MF and in none out of 11 patients with inflammatory skin diseases. CONCLUSION: TCR gamma gene rearrangement studies on lesional skin using PCR may be helpful as an adjunct to the histopathologic diagnosis of early MF.

Two Step Polymerase Chain Reaction Detecting the T Cell Receptor Gene Rearrangement in Cutaneous T Cell Lymphoma / 中华皮肤科杂志

Objective A two step polymerase chain reaction (PCR) strategy was used to amplify copy DNAs corresponding to the special region of the T cell receptor (TCR) ? chain. Methods and Results With this technique, a dominant TCR gene rearrangement that used the ?8 variable region gene segment was identified in a patient with cuteneous T cell lymphoma and its sequence determined from multiple independently generated subclonal PCR products. An oligonucleotide corresponding to the highly variable junctional region of the clonally expanded TCR gene rearrangement was synthesized and used for further confirming studies. Finally, from the sequence data obtained, a peptide corresponding to the ? chain junctional region sequence of the patient′s clonally expanded T cells was generated. Conclusion Preliminary studies using this peptide indicate that it is antigenic and may potentially be useful in developing a patient specific tumour vaccine.