T-Cell Clonality Analysis in the Diagnosis of Cutaneous Lymphomas: Comparative Efficacy of Methods

Liliya Gamilevna Gorenkova, Yu.V. Sidorova, B.V. Biderman, N.V. Ryzhikova, M.A. Mozdon, E.O. Terekhova, Z.M. Omarova, E.E. Zvonkov, A.B. Sudarikov,

DOI:

https://doi.org/10.21320/2500-2139-2026-19-4-392-399

BACKGROUND. A clonal population of T-lymphocytes consists of single-lymphocyte progenies with the same antigen specificity and identical nucleotide sequence of rearranged T-cell receptor (TCR) genes. The TCR locus rearrangement occurs sequentially during T-lymphocyte differentiation: the earliest rearrangement is in the TRD gene, followed by TRG, TRB, and TRA. Since in most T-cell cutaneous lymphomas, which are primarily of αβ T-cell type, all TCR loci are rearranged, it is sufficient to analyze the TRG and TRB loci using PCR to determine clonality. One of the diagnostic issues is a high rate of false-negative results (33–48 %) at the early stages of mycosis fungoides (MF), which shows a clear need to compare specificity and sensitivity of clonality determination by TRG and TRB loci using capillary electrophoresis (CE) as well as to study the diagnostic potential of high-throughput sequencing (HTS).

AIM. To figure out the best strategy and method for identifying T-cell clonality in skin biopsies.

MATERIALS & METHODS. This study is based on analyzing 161 skin biopsies by CE and 31 skin biopsies by CE and HTS.

RESULTS. The results of CE for TRG and TCB genes were consistent in 88 % (141 out of 161) of the samples studied: 71 TRG+/TRB+, 69 TRG–/TRB–, and 1 TRG±/TRB±. In 14 out of 16 discordant cases with evidence of monoclonality at one of the loci, T-cell lymphoma was diagnosed. In patients with uncertain clonality at one of the loci but polyclonality at another locus, a non-neoplastic skin lesion was identified. To compare CE and HTS methods, the analysis focused on 14 skin samples (12 patients) and 11 peripheral blood samples from MF patients as well as 17 skin samples from the patients with non-neoplastic dermatosis by TRG and TRB loci. The comparison of CE and HTS results did not yield any critical differences in assessing clonality: in patients with polyclonal CE result, many clonal products were identified by HTS with the dominant clone accounting for less than 6.1 %, and the other way round, the monoclonal CE result corresponded to HTS reporting the dominant TRG or TRB clone with allelic load of > 5.5 %.

CONCLUSION. In skin biopsis with cutaneous T-cell lymphoma suspicion, CE analysis of TRG locus is sufficient to report clonality; if the result is negative, TRB locus should be analyzed as well. The use of HTS is well justified at the early MF stages with atypically aggressive course, when it is required to provide a quantitative assessment of the clonal product in an affected area or to evaluate minimal disseminated disease.

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Keywords:

cutaneous lymphomas, Т-cell clonality, PCR, capillary electrophoresis, high-throughput sequencing

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  • Liliya Gamilevna Gorenkova, MD, PhD, National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167, e-mail: l.aitova@mail.ru

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01.10.2026

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Vol. 19 No. 4 (2026)
LYMPHOID TUMORS

How to Cite

Gorenkova L.G., Sidorova Y.V., Biderman B.V., et al. T-Cell Clonality Analysis in the Diagnosis of Cutaneous Lymphomas: Comparative Efficacy of Methods. Clinical Oncohematology. Basic Research and Clinical Practice. 2026;19(4):392–399. doi:10.21320/2500-2139-2026-19-4-392-399.

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