BACKGROUND The diagnosis of T-cell neoplasms is often challenging, due to overlapping features with reactive T-cells and limitations of currently available T-cell clonality assays. The description of an antibody specific for one of two mutually exclusive T-cell receptor (TCR) β-chain constant regions (TRBC1) provide an opportunity to facilitate the detection of clonal TCRαβ T-cells based on TRBC-restriction. METHODS Twenty patients with mature T-cell neoplasms and 44 patients without evidence of T-cell neoplasia were studied. Peripheral blood (51), bone marrow (10), and lymph node (3) specimens were evaluated by 9-color flow cytometry including TRBC1 (CD2/CD3/CD4/CD5/CD7/CD8/CD45/TCRγδ/TRBC1 and/or CD2/CD3/CD4/CD5/CD7/CD8/CD26/CD45/TRBC1). Monophasic TRBC1 expression on any immunophenotypically distinct CD4-positive or CD8-positive/TCRγδ-negative T-cell subset was considered indicative of clonality. RESULTS Monophasic (clonal) TRBC1 expression was identified on immunophenotypically abnormal T-cells from all 20 patients with T-cell malignancies (100% sensitivity), including 17 cases with either >97% or <3% TRBC1-positive events, and three cases with monophasic homogenous TRBC1-dim expression. All immunophenotypically distinct CD4-positive and CD8-positive/TCRγδ-negative T-cell subsets from 44 patients without T-cell malignancies showed the expected mixture of TRBC1-positive and TRBC-1-negative subpopulations (non-clonal), except for seven patients (16%) with very small CD8-positive T-cell subsets exhibiting a monophasic (clonal) pattern. CONCLUSION Inclusion of a single anti-TRBC1 antibody into a diagnostic T-cell flow cytometry panel facilitates the rapid identification of T-cell neoplasms, in addition to small monotypic CD8-positive subsets of uncertain significance. © 2019 International Clinical Cytometry Society.

中文翻译：

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通过流式细胞术检测T细胞受体αβ克隆的单抗体可快速鉴定出成熟的T细胞肿瘤和具有不确定意义的单型CD8阳性小亚型。

背景技术由于与反应性T细胞的特征重叠以及当前可用的T细胞克隆性测定法的局限性，T细胞肿瘤的诊断通常具有挑战性。对两个互斥的T细胞受体（TCR）β链恒定区（TRBC1）之一特异的抗体的描述为基于TRBC限制性检测克隆TCRαβT细胞提供了机会。方法研究20例具有成熟T细胞肿瘤的患者和44例无T细胞瘤形成证据的患者。通过9色流式细胞术评估外周血（51），骨髓（10）和淋巴结（3）标本，包括TRBC1（CD2 / CD3 / CD4 / CD5 / CD7 / CD8 / CD45 /TCRγδ/ TRBC1和/或CD2 / CD3 / CD4 / CD5 / CD7 / CD8 / CD26 / CD45 / TRBC1）。任何免疫表型不同的CD4阳性或CD8阳性/TCRγδ阴性的T细胞亚群上的单相TRBC1表达被认为是克隆性的指示。结果在所有20例T细胞恶性肿瘤（敏感性为100％）患者的免疫表型异常T细胞中鉴定出单相（克隆）TRBC1表达，包括17例TRBC1阳性事件> 97％或<3％的病例，其中3例具有单相同质TRBC1-dim表达。来自44个无T细胞恶性肿瘤的患者的所有免疫表型不同的CD4阳性和CD8阳性/TCRγδ阴性的T细胞亚群均显示了预期的TRBC1阳性和TRBC-1阴性亚群的混合（非克隆）具有非常小的CD8阳性T细胞亚群的患者（16％）表现出单相（克隆）模式。结论除了具有不确定意义的小的单型CD8阳性子集外，将单一抗TRBC1抗体包含在诊断性T细胞流式细胞仪中有助于快速鉴定T细胞肿瘤。©2019国际临床细胞计量学会。