对疑似真菌病皮肤活检组织进行两种 T 细胞受体-γ 克隆测定的比较

IF 1.1 4区 医学 Q4 DERMATOLOGY American Journal of Dermatopathology Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI:10.1097/DAD.0000000000002654
Stan Miller, Travis Vandergriff, Heather Woodworth Goff, Jing Xu, Dwight Oliver
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引用次数: 0

摘要

摘要:诊断实验室广泛使用基于 PCR 的 T 细胞受体(TCR)基因片段分析来评估多个组织部位 T 细胞群的克隆性。在已报道的众多 TCR 检测方法中,还缺乏专门针对疑似真菌病活检组织的评估研究。我们比较了以前在福尔马林固定的皮肤活检组织上使用的 2 管/2-荧光染料检测法和重新设计的 1 管/1-荧光染料检测法得出的克隆性结果。总体而言,以临床病史结合组织学诊断作为金标准,2 管检测法的准确率略高(75.7% 对 71.4%)。双管检测法的灵敏度更高(73.7% 对 65.8%),而单管检测法的特异性更高(93.8% 对 87.5%)。单管检测法更容易解释克隆结果。在近 19% 的病例中,对同一活组织切片更换检测方法会导致克隆性解释的改变。对于更换TCR-γ克隆性检测方法的实验室来说,为评估真菌病而进行的后续活检可能会导致诊断结果的改变。
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Comparison of 2 T-Cell Receptor-γ Clonality Assays on Skin Biopsies Suspicious for Mycosis Fungoides.

Abstract: PCR-based fragment analysis of the T-cell receptor (TCR) gene is used extensively in diagnostic labs to assess clonality in T-cell populations in multiple tissue sites. Of the numerous TCR assays that have been reported, studies assessing use on biopsies suspicious for mycosis fungoides specifically are lacking. We compared clonality findings from a previously run 2-tube/2-fluorochrome dye assay to a redesigned 1-tube/1-fluorochrome dye assay on formalin-fixed skin biopsies. Overall, the accuracy of the 2-tube assay was marginally better (75.7% vs. 71.4%), when using clinical history combined with histologic diagnosis as the gold standard. The 2-tube assay had better sensitivity (73.7% vs. 65.8%), while the 1-tube assay had superior specificity (93.8% vs. 87.5%). Clonality results were easier to interpret with the 1-tube assay. In nearly 19% of cases, a change of assays on the same biopsy resulted in a change of clonality interpretation. For laboratories that change TCR-γ clonality assays, follow-up biopsies for mycosis fungoides assessment may result in a change of diagnosis.

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来源期刊
CiteScore
1.80
自引率
9.10%
发文量
453
审稿时长
3 months
期刊介绍: The American Journal of Dermatopathology offers outstanding coverage of the latest diagnostic approaches and laboratory techniques, as well as insights into contemporary social, legal, and ethical concerns. Each issue features review articles on clinical, technical, and basic science advances and illuminating, detailed case reports. With the The American Journal of Dermatopathology you''ll be able to: -Incorporate step-by-step coverage of new or difficult-to-diagnose conditions from their earliest histopathologic signs to confirmatory immunohistochemical and molecular studies. -Apply the latest basic science findings and clinical approaches to your work right away. -Tap into the skills and expertise of your peers and colleagues the world over peer-reviewed original articles, "Extraordinary cases reports", coverage of practical guidelines, and graphic presentations. -Expand your horizons through the Journal''s idea-generating forum for debating controversial issues and learning from preeminent researchers and clinicians
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