Fujii Kazuyasu, Kanekura Takuro
Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Front Med (Lausanne). 2019 Aug 13;6:181. doi: 10.3389/fmed.2019.00181. eCollection 2019.
The diagnosis of early stage cutaneous T-cell lymphoma is often difficult, particularly in mycosis fungoides (MF), because the clinical presentation, histological findings, and laboratory findings of MF resemble those of inflammatory skin diseases such as atopic dermatitis, psoriasis, and parapsoriasis en plaque. Furthermore, MF sometimes occurs with or after these inflammatory skin diseases. The current diagnostic criteria heavily rely on clinical impressions along with assessments of T cell clonality. To make a diagnosis of early-stage MF, the detection of a malignant clone is critical. T cell receptor (TCR) gene rearrangements have been detected by southern blotting or polymerase chain reaction for this purpose, but the results of these methods are insufficient. High-throughput TCR sequencing has provided insights into the complexities of the immune repertoire. Accordingly, his technique is more sensitive and specific than current methods, making it useful for the detection of early lesions and monitoring responses to therapy.
早期皮肤T细胞淋巴瘤的诊断通常很困难，尤其是蕈样肉芽肿（MF），因为MF的临床表现、组织学发现和实验室检查结果与特应性皮炎、银屑病和斑块状副银屑病等炎症性皮肤病相似。此外，MF有时与这些炎症性皮肤病同时发生或在其之后出现。目前的诊断标准严重依赖临床印象以及T细胞克隆性评估。要诊断早期MF，检测恶性克隆至关重要。为此，已通过Southern印迹法或聚合酶链反应检测T细胞受体（TCR）基因重排，但这些方法的结果并不充分。高通量TCR测序为免疫库的复杂性提供了见解。因此，这项技术比现有方法更敏感、更特异，有助于早期病变的检测和治疗反应的监测。
