The significance of multiplex PCR/heteroduplex analysis‐based TCR‐γ gene rearrangement combined with laser‐capture microdissection in the diagnosis of early mycosis fungoides

Background: The diagnosis of early mycosis fungoides (MF) is a big challenge to dermatologists and dermatopathologists because it lacks specific clinicopathologic features. Methods: Fifty-two paraffin-embedded skin samples from 50 patients, including 31 with suspected MF, 10 with typical MF and 9 with benign inflammatory dermatosis (BID), were obtained from our archives. DNA was extracted both by traditional phenol-chloroform method and by the laser-capture microdissection (LCM)-proteinase K approach. The TVG/TJG, V2–5/V8–12/JGT1 and BIOMED-2-TCR-γ primers were used to assess TCR-γ monoclonal rearrangement as measured by polymerase chain reaction (PCR). Results: In the suspected MF group, clonal TCR-γ gene rearrangements were detected in 11/31 cases (35.5%) by phenol-chloroform DNA extraction and in 25/31 cases (80.7%) by LCM-proteinase K extraction (p 0.05) in the typical MF group, no TCR-γ monoclonal rearrangement was detected in the BID group. Conclusions: The strategy of multiple PCR/heteroduplex analysis for TCR-γ gene rearrangement combined with LCM increases the detection rate of clonal TCR-γ gene rearrangement in early MF cases and could provide strong evidence to confirm the diagnosis of early MF. Yang H, Xu C, Tang Y, Wan C, Liu W, Wang L. The significance of multiplex PCR/heteroduplex analysis-based TCR-γ gene rearrangement combined with laser-capture microdissection in the diagnosis of early mycosis fungoides.