Restricted Expression of the Constant Region 1 of T-Cell Receptor β by Flow Cytometry Facilitates Detection of T-Cell Neoplasms With High Specificity but Moderate Predictive Value
(2025) In European Journal of Haematology- Abstract
Objectives: To determine the diagnostic value of disclosing monotypic T-cell populations by expression analysis of the constant region 1 of T-cell receptor β (TRBC1) by flow cytometry, for the detection of T-cell neoplasms, in a routine hematopathology practice setting. Methods: A panel of antibodies ECD-CD16/PECy5.5-CD4/PECy7-CD2/APCAF700-CD7/KO-CD8/FITC-TCRγδ/PE-TRBC1/APC-CD26/APC-CD57/APC-CD30/APCH7-CD45/BV421-CD3 was applied. One thousand and twenty-nine cases investigated during 26 months were reviewed and categorized as monotypic or polytypic depending on the expression of TRBC1 in all identifiable CD3+ T-cell subsets. Results: Although TRBC1 restriction proved to be sensitive (90.7%) with a high negative predictive value (99.1%),... (More)
Objectives: To determine the diagnostic value of disclosing monotypic T-cell populations by expression analysis of the constant region 1 of T-cell receptor β (TRBC1) by flow cytometry, for the detection of T-cell neoplasms, in a routine hematopathology practice setting. Methods: A panel of antibodies ECD-CD16/PECy5.5-CD4/PECy7-CD2/APCAF700-CD7/KO-CD8/FITC-TCRγδ/PE-TRBC1/APC-CD26/APC-CD57/APC-CD30/APCH7-CD45/BV421-CD3 was applied. One thousand and twenty-nine cases investigated during 26 months were reviewed and categorized as monotypic or polytypic depending on the expression of TRBC1 in all identifiable CD3+ T-cell subsets. Results: Although TRBC1 restriction proved to be sensitive (90.7%) with a high negative predictive value (99.1%), in some T-cell neoplasms, particularly those with significant inflammation, including angioimmunoblastic T-cell lymphoma, monotypic T-cells were not detected. The specificity was high (95.6%) albeit with a modest positive predictive value (67.1%), reflecting T-cell clones of uncertain significance (T-CUS) without T-cell neoplasm. Of these clones, 53.6% exhibited a T-cell large granular lymphocytic leukemia-like phenotype, most commonly found in the peripheral blood or bone marrow, while others were identified in association with unrelated primary tumors or other comorbidities. Seventy-nine percent of the T-CUS cases remained stable over time during 1–77 months of follow-up. Conclusion: Including TRBC1 antibodies in a routine flow cytometry panel facilitates the identification of T-cell neoplasms. The analysis must be interpreted within its clinical context since T-cell lymphomas with a small and sometimes surface CD3-negative neoplastic T cell population, may display normal patterns of TRBC1-expression with a background of reactive T cells. Conversely, monotypic T-cells can be found in the absence of T-cell neoplasm.
(Less)
- author
- Rajabian, Nilofar LU ; Axler, Olof LU ; Wistén, Erik ; Porwit, Anna LU and Ehinger, Mats LU
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- clones, flow cytometry, sensitivity, specificity, T-cell lymphoma, T-cell receptor
- in
- European Journal of Haematology
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:105023283171
- pmid:41317167
- ISSN
- 0902-4441
- DOI
- 10.1111/ejh.70067
- language
- English
- LU publication?
- yes
- id
- dae15876-b702-44ed-80b1-7a723e280f04
- date added to LUP
- 2026-02-04 11:10:17
- date last changed
- 2026-02-05 03:00:06
@article{dae15876-b702-44ed-80b1-7a723e280f04,
abstract = {{<p>Objectives: To determine the diagnostic value of disclosing monotypic T-cell populations by expression analysis of the constant region 1 of T-cell receptor β (TRBC1) by flow cytometry, for the detection of T-cell neoplasms, in a routine hematopathology practice setting. Methods: A panel of antibodies ECD-CD16/PECy5.5-CD4/PECy7-CD2/APCAF700-CD7/KO-CD8/FITC-TCRγδ/PE-TRBC1/APC-CD26/APC-CD57/APC-CD30/APCH7-CD45/BV421-CD3 was applied. One thousand and twenty-nine cases investigated during 26 months were reviewed and categorized as monotypic or polytypic depending on the expression of TRBC1 in all identifiable CD3+ T-cell subsets. Results: Although TRBC1 restriction proved to be sensitive (90.7%) with a high negative predictive value (99.1%), in some T-cell neoplasms, particularly those with significant inflammation, including angioimmunoblastic T-cell lymphoma, monotypic T-cells were not detected. The specificity was high (95.6%) albeit with a modest positive predictive value (67.1%), reflecting T-cell clones of uncertain significance (T-CUS) without T-cell neoplasm. Of these clones, 53.6% exhibited a T-cell large granular lymphocytic leukemia-like phenotype, most commonly found in the peripheral blood or bone marrow, while others were identified in association with unrelated primary tumors or other comorbidities. Seventy-nine percent of the T-CUS cases remained stable over time during 1–77 months of follow-up. Conclusion: Including TRBC1 antibodies in a routine flow cytometry panel facilitates the identification of T-cell neoplasms. The analysis must be interpreted within its clinical context since T-cell lymphomas with a small and sometimes surface CD3-negative neoplastic T cell population, may display normal patterns of TRBC1-expression with a background of reactive T cells. Conversely, monotypic T-cells can be found in the absence of T-cell neoplasm.</p>}},
author = {{Rajabian, Nilofar and Axler, Olof and Wistén, Erik and Porwit, Anna and Ehinger, Mats}},
issn = {{0902-4441}},
keywords = {{clones; flow cytometry; sensitivity; specificity; T-cell lymphoma; T-cell receptor}},
language = {{eng}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Haematology}},
title = {{Restricted Expression of the Constant Region 1 of T-Cell Receptor β by Flow Cytometry Facilitates Detection of T-Cell Neoplasms With High Specificity but Moderate Predictive Value}},
url = {{http://dx.doi.org/10.1111/ejh.70067}},
doi = {{10.1111/ejh.70067}},
year = {{2025}},
}