Beck Rose C, Stahl Steve, O'Keefe Christine L, Maciejewski Jaroslaw P, Theil Karl S, Hsi Eric D
Division of Pathology and Laboratory Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Am J Clin Pathol. 2003 Nov;120(5):785-94. doi: 10.1309/835B-04QX-GNNF-NRJU.
A broad array of antibodies directed against the variable (V) region of the T-cell receptor (TCR) beta (V beta) chain has become available in a directly conjugated multicolor format that permits assessment of 19 of 25 V beta families, covering 70% of the normal circulating T-cell repertoire. These antibodies were used to detect expanded T-cell populations in 43 peripheral blood samples submitted for suspected T-cell malignancy. Of 43 samples, 27 were diagnosed as follows: T-cell large granular lymphocyte leukemia, 14 samples; Sézary syndrome, 4 samples; T-cell prolymphocytic leukemia, 5 samples; or T-cell non-Hodgkin lymphoma or T-cell lymphoproliferative disorder not otherwise specified, 4 samples. The remaining 16 samples were determined to be nonneoplastic. All samples were diagnosed before assessment with anti-V beta flow cytometry. By using a cutoff of 1.6 times the upper limit of normal range (ULN) to define malignant restriction of V beta use, pathologic restriction of V beta use was found directly or indirectly in all 27 samples carrying a diagnosis of malignancy and directly in 2 of 16 samples without a diagnosis of malignancy. TCR gene rearrangement studies were used to confirm V beta flow cytometry results. By using a cutoff of 1.6 times the ULN for the detection of malignancy, the antibody panel had a diagnostic sensitivity of 89% for direct detection of pathologic V beta restriction and a specificity of 88%, making it useful for rapid diagnosis of T-cell leukemia.
一系列针对T细胞受体（TCR）β链可变（V）区（Vβ）的抗体已制成直接偶联的多色形式，可用于评估25个Vβ家族中的19个，覆盖正常循环T细胞库的70%。这些抗体用于检测提交疑似T细胞恶性肿瘤的43份外周血样本中扩增的T细胞群体。在43份样本中，27份诊断如下：T细胞大颗粒淋巴细胞白血病，14份样本；Sezary综合征，4份样本；T细胞原淋巴细胞白血病，5份样本；或未另行指定的T细胞非霍奇金淋巴瘤或T细胞淋巴增殖性疾病，4份样本。其余16份样本被确定为非肿瘤性。所有样本在进行抗Vβ流式细胞术评估之前均已确诊。通过使用正常范围上限（ULN）的1.6倍作为界定Vβ使用恶性限制的临界值，在所有27份诊断为恶性肿瘤的样本中直接或间接发现了Vβ使用的病理限制，在16份未诊断为恶性肿瘤的样本中有2份直接发现了这种限制。TCR基因重排研究用于确认Vβ流式细胞术结果。通过使用ULN的1.6倍作为检测恶性肿瘤的临界值，该抗体组对病理Vβ限制的直接检测诊断敏感性为89%，特异性为88%，使其可用于T细胞白血病的快速诊断。
