Sensitivity and specificity of T-cell receptor PCR BIOMED-2 clonality analysis for the diagnosis of cutaneous T-cell lymphoma

Eur J Dermatol. 2020 Feb 1;30(1):12-15. doi: 10.1684/ejd.2020.3698.

Abstract

Background: Early and precise diagnosis of cutaneous T-cell lymphomas (CTCL) is challenging. Currently, polymerase chain reaction (PCR)-based clonality assessment of the T-cell receptor (TCR) is a helpful tool for this diagnosis.

Objectives: In this retrospective study, we aimed to assess the sensitivity and specificity of this method for the diagnosis of CTCL.

Materials and methods: Monoclonal rearrangement of the TCR was investigated retrospectively by PCR-based clonality assessment based on 292 DNA samples from skin biopsies of patients with a suspicion of CTCL. Algorithms were based on different ratios (three or five-fold difference) between the dominant PCR peak and the third highest PCR peak.

Results: A PCR peak five-fold higher than the third highest PCR peak demonstrated significantly greater specificity (83.7% versus 76.4%) but lower sensitivity (59.8% versus 68.6%) compared to a cut-off of three-fold higher.

Conclusion: Our results confirm the diagnostic value of TCR clonality analysis which may be used to define the ideal cut-off in order to optimize sensitivity and specificity.

Keywords: BIOMED-2; T-cell receptor; clonality; cutaneous lymphoma.

MeSH terms

  • Aged
  • Algorithms
  • Biopsy
  • DNA / analysis*
  • Female
  • Humans
  • Lymphoma, T-Cell, Cutaneous / diagnosis*
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Receptors, Antigen, T-Cell / genetics*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Skin / pathology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology

Substances

  • Receptors, Antigen, T-Cell
  • DNA