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Molecular staging of lymph nodes from 60 patients with mycosis fungoides and Sézary syndrome: correlation with histopathology and outcome suggests prognostic relevance in mycosis fungoides.
Br J Dermatol 2006; 155(4):756-62BJ

Abstract

BACKGROUND

Histological evidence of lymph node involvement is associated with a poor prognosis in patients with cutaneous T-cell lymphoma (CTCL).

OBJECTIVES

To determine whether T-cell receptor (TCR) gene analysis is of prognostic relevance in CTCL.

METHODS

TCR gene analysis was performed on lymph node specimens from 60 patients with mycosis fungoides (MF) and Sézary syndrome (SS) using a highly sensitive polymerase chain reaction (PCR)/single-strand conformational polymorphism analysis and results were correlated with skin, overall clinical and histological lymph node stages.

RESULTS

The frequency with which a T-cell clone was detected in lymph node samples from patients with MF increased with skin stage, overall clinical stage and with the degree of histological involvement: six of 19 patients with uninvolved lymph nodes or limited histological involvement (LN0-2) and 13 of 14 patients with advanced histological involvement (LN3-4) had a detectable T-cell clone. In SS, 22 of 27 patients had a detectable lymph node T-cell clone. The clonal patients had a poorer prognosis than nonclonal patients (median survival from biopsy of > 72 months vs. 16 months for MF and 41.5 vs. 16.5 months for SS). Regression analysis confirmed that TCR gene analysis identifies a group of MF patients with a worse prognosis (P = 0.013). However, the molecular lymph node stage did not provide independent prognostic information in this cohort of patients in multivariate analysis.

CONCLUSIONS

Molecular staging in MF and SS using a PCR-based method for TCR gene analysis provides additional information to histological examination. Specifically, this study identified a group of MF patients with early lymph node involvement with a poorer prognosis. However, a larger prospective study of patients with MF and early histological lymph node involvement is required to confirm whether molecular staging of lymph nodes provides independent prognostic information in a multivariate model.

Authors+Show Affiliations

Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, UK. elizabeth.fraser-andrews@essexrivers.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16965425

Citation

Fraser-Andrews, E A., et al. "Molecular Staging of Lymph Nodes From 60 Patients With Mycosis Fungoides and Sézary Syndrome: Correlation With Histopathology and Outcome Suggests Prognostic Relevance in Mycosis Fungoides." The British Journal of Dermatology, vol. 155, no. 4, 2006, pp. 756-62.
Fraser-Andrews EA, Mitchell T, Ferreira S, et al. Molecular staging of lymph nodes from 60 patients with mycosis fungoides and Sézary syndrome: correlation with histopathology and outcome suggests prognostic relevance in mycosis fungoides. Br J Dermatol. 2006;155(4):756-62.
Fraser-Andrews, E. A., Mitchell, T., Ferreira, S., Seed, P. T., Russell-Jones, R., Calonje, E., & Whittaker, S. J. (2006). Molecular staging of lymph nodes from 60 patients with mycosis fungoides and Sézary syndrome: correlation with histopathology and outcome suggests prognostic relevance in mycosis fungoides. The British Journal of Dermatology, 155(4), pp. 756-62.
Fraser-Andrews EA, et al. Molecular Staging of Lymph Nodes From 60 Patients With Mycosis Fungoides and Sézary Syndrome: Correlation With Histopathology and Outcome Suggests Prognostic Relevance in Mycosis Fungoides. Br J Dermatol. 2006;155(4):756-62. PubMed PMID: 16965425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular staging of lymph nodes from 60 patients with mycosis fungoides and Sézary syndrome: correlation with histopathology and outcome suggests prognostic relevance in mycosis fungoides. AU - Fraser-Andrews,E A, AU - Mitchell,T, AU - Ferreira,S, AU - Seed,P T, AU - Russell-Jones,R, AU - Calonje,E, AU - Whittaker,S J, PY - 2006/9/13/pubmed PY - 2007/3/3/medline PY - 2006/9/13/entrez SP - 756 EP - 62 JF - The British journal of dermatology JO - Br. J. Dermatol. VL - 155 IS - 4 N2 - BACKGROUND: Histological evidence of lymph node involvement is associated with a poor prognosis in patients with cutaneous T-cell lymphoma (CTCL). OBJECTIVES: To determine whether T-cell receptor (TCR) gene analysis is of prognostic relevance in CTCL. METHODS: TCR gene analysis was performed on lymph node specimens from 60 patients with mycosis fungoides (MF) and Sézary syndrome (SS) using a highly sensitive polymerase chain reaction (PCR)/single-strand conformational polymorphism analysis and results were correlated with skin, overall clinical and histological lymph node stages. RESULTS: The frequency with which a T-cell clone was detected in lymph node samples from patients with MF increased with skin stage, overall clinical stage and with the degree of histological involvement: six of 19 patients with uninvolved lymph nodes or limited histological involvement (LN0-2) and 13 of 14 patients with advanced histological involvement (LN3-4) had a detectable T-cell clone. In SS, 22 of 27 patients had a detectable lymph node T-cell clone. The clonal patients had a poorer prognosis than nonclonal patients (median survival from biopsy of > 72 months vs. 16 months for MF and 41.5 vs. 16.5 months for SS). Regression analysis confirmed that TCR gene analysis identifies a group of MF patients with a worse prognosis (P = 0.013). However, the molecular lymph node stage did not provide independent prognostic information in this cohort of patients in multivariate analysis. CONCLUSIONS: Molecular staging in MF and SS using a PCR-based method for TCR gene analysis provides additional information to histological examination. Specifically, this study identified a group of MF patients with early lymph node involvement with a poorer prognosis. However, a larger prospective study of patients with MF and early histological lymph node involvement is required to confirm whether molecular staging of lymph nodes provides independent prognostic information in a multivariate model. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/16965425/Molecular_staging_of_lymph_nodes_from_60_patients_with_mycosis_fungoides_and_Sézary_syndrome:_correlation_with_histopathology_and_outcome_suggests_prognostic_relevance_in_mycosis_fungoides_ L2 - https://doi.org/10.1111/j.1365-2133.2006.07428.x DB - PRIME DP - Unbound Medicine ER -