意义不明的 T 细胞克隆非常普遍，与 T 细胞大颗粒淋巴细胞白血病非常相似。对实验室诊断的影响。,Modern Pathology

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意义不明的 T 细胞克隆非常普遍，与 T 细胞大颗粒淋巴细胞白血病非常相似。对实验室诊断的影响。
Modern Pathology ( IF 7.1 ) Pub Date : 2020-05-13 , DOI: 10.1038/s41379-020-0568-2
Min Shi ₁ , Horatiu Olteanu ₁ , Dragan Jevremovic ₁ , Rong He ₁ , David Viswanatha ₁ , Heidi Corley ₁ , Pedro Horna ₁

Affiliation

反应性免疫反应中的良性克隆 T 细胞扩增通常使实验室诊断 T 细胞瘤变复杂。我们最近推出了一种新的流式细胞术检测方法，基于表型不同的 TCRαβ 中单相 T 细胞受体 (TCR) β 链恒定区 1 (TRBC1) 表达模式的鉴定，检测血液和骨髓中的 T 细胞克隆T 细胞亚群。在常规实验室实践中，在 159 名无 T 细胞恶性肿瘤患者中的 42 名 (26%) 和 24 名 (13%) 健康供体中的 3 名患者中检测到意义不明的 T 细胞克隆 (T-CUS)。它们的表型（CD8+/CD4-：78%，CD4-/CD8-：12%，CD4+/CD8+：9%，或 CD4+/CD8-：2%）与 26 例 T 细胞大颗粒淋巴细胞白血病的表型非常相似(T-LGLL) 进行了类似的研究，除了克隆大小小得多 (p < 0.0001)，CD2 和 CD7 稍亮，和稍微暗淡的 CD3 表达 (p < 0.05)。T-CUS 与年龄、性别、合并症或外周血细胞计数无关。TCR-Vβ 曲目分析证实了 T-CUS 的克隆性，并在与 TRBC1 分析相结合时确定了额外的克隆型 CD8 阳性亚群。我们在此报告了没有明显 T 细胞瘤形成的患者的表型特征和克隆 T 细胞亚群的发生率，为根据 T 细胞克隆的大小和表型特性进行差异解释提供了一个框架。

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T-cell clones of uncertain significance are highly prevalent and show close resemblance to T-cell large granular lymphocytic leukemia. Implications for laboratory diagnostics.

Benign clonal T-cell expansions in reactive immune responses often complicate the laboratory diagnosis T-cell neoplasia. We recently introduced a novel flow cytometry assay to detect T-cell clones in blood and bone marrow, based on the identification of a monophasic T-cell receptor (TCR) β chain constant region-1 (TRBC1) expression pattern within a phenotypically distinct TCRαβ T-cell subset. In routine laboratory practice, T-cell clones of uncertain significance (T-CUS) were detected in 42 of 159 (26%) patients without T-cell malignancy, and in 3 of 24 (13%) healthy donors. Their phenotype (CD8+/CD4-: 78%, CD4-/CD8-: 12%, CD4+/CD8+: 9%, or CD4+/CD8-: 2%) closely resembled that of 26 cases of T-cell large granular lymphocytic leukemia (T-LGLL) studied similarly, except for a much smaller clone size (p < 0.0001), slightly brighter CD2 and CD7, and slightly dimmer CD3 expression (p < 0.05). T-CUS was not associated with age, gender, comorbidities, or peripheral blood counts. TCR-Vβ repertoire analysis confirmed the clonality of T-CUS, and identified additional clonotypic CD8-positive subsets when combined with TRBC1 analysis. We hereby report the phenotypic features and incidence of clonal T-cell subsets in patients with no demonstrable T-cell neoplasia, providing a framework for the differential interpretation of T-cell clones based on their size and phenotypic properties.

更新日期：2020-05-13

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