{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:58:48Z","timestamp":1790855928802,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["107-003823"],"award-info":[{"award-number":["107-003823"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The diagnostic challenges in early mycosis fungoides (MF) and other cutaneous T-cell lymphomas (CTCLs) persist despite advancements in molecular methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To provide a preliminary assessment of next-generation sequencing (NGS) in analysing TRG (T-cell receptor gamma locus) sequences for distinguishing CTCLs from benign inflammatory skin disorders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>NGS was used to assess TRG sequences in skin samples from clinicopathologically proven CTCLs and benign inflammatory skin disorders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our study analysed skin samples from a total of 36 participants, comprising 22 cases of CTCL, including 14 MF and 8 other CTCLs, alongside 14 cases of benign inflammatory skin disorders. According to LymphoTrack\u00ae criteria, monoclonality was detected in 16 (73%) of the 22 patients with CTCL. Specifically, in cases of MF, 10 of 14 (71%) were identified as monoclonal, with all 4 non-monoclonal cases being in the patch stage. For the other cases of CTCL, six of eight displayed monoclonality. Among the 22 patients with CTCL, 10 (45%) had multiple biopsies, with 8 (36%) displaying the same dominant clone across different sites. Among the 14 benign cases, only the case of erythrodermic psoriasis exhibited monoclonality. Our decision tree analysis suggests that a high frequency of the most abundant clone, its ratio to the third most abundant clone and TRG V\u03b3I segment usage are effective markers that can help in the diagnosis of CTCL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A combination of the clone frequencies and TRG V segment usage may enhance diagnosis of MF and other CTCLs, helping to differentiate them from benign conditions. However, molecular diagnosis for patch-stage MF remains challenging.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llae413","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T21:34:30Z","timestamp":1730928870000},"page":"788-794","source":"Crossref","is-referenced-by-count":1,"title":["Preliminary assessment of the accuracy of cutaneous T-cell lymphoma diagnosis through deep sequencing of the <i>TRG<\/i> gene"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-6463","authenticated-orcid":false,"given":"Jin-Bon","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Dermatology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyng-Shiuan","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1498-1474","authenticated-orcid":false,"given":"Tsen-Fang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jau-Yu","family":"Liau","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Ching","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung-Lung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1625-7295","authenticated-orcid":false,"given":"Tai-Chung","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"2025032702501669500_llae413-B1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/j.1468-3083.2004.00937.x","article-title":"Clinicopathological spectrum of mycosis fungoides","volume":"18","author":"Kazakov","year":"2004","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025032702501669500_llae413-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2133.2006.07526.x","article-title":"Mycosis fungoides: a dermatological masquerader","volume":"156","author":"Nashan","year":"2007","journal-title":"Br J Dermatol"},{"key":"2025032702501669500_llae413-B3","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/j.1600-0560.2006.00662.x","article-title":"Histologic mimickers of mycosis fungoides: a review","volume":"34","author":"Reddy","year":"2007","journal-title":"J Cutan Pathol"},{"key":"2025032702501669500_llae413-B4","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1182\/blood.V78.1.192.192","article-title":"Gene rearrangement in B- and T-lymphoproliferative disease detected by the polymerase chain reaction","volume":"78","author":"Trainor","year":"1991","journal-title":"Blood"},{"key":"2025032702501669500_llae413-B5","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF00191340","article-title":"Gene rearrangements and chromosomal translocations in T cell lymphoma \u2013 diagnostic applications and their limits","volume":"426","author":"Griesser","year":"1995","journal-title":"Virchows Arch"},{"key":"2025032702501669500_llae413-B6","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1136\/jcp.48.11.1045","article-title":"The polymerase chain reaction in the demonstration of monoclonality in T cell lymphomas","volume":"48","author":"Diss","year":"1995","journal-title":"J Clin Pathol"},{"key":"2025032702501669500_llae413-B7","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1084-8592(99)80036-8","article-title":"Enhanced sensitivity with a novel TCR\u03b3 PCR assay for clonality studies in 569 \u00adformalin-fixed, paraffin-embedded (FFPE) cases","volume":"4","author":"Krafft","year":"1999","journal-title":"Mol Diagn"},{"key":"2025032702501669500_llae413-B8","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1038\/sj.leu.2403202","article-title":"Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936","volume":"17","author":"van Dongen","year":"2003","journal-title":"Leukemia"},{"key":"2025032702501669500_llae413-B9","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1182\/blood-2007-03-055749","article-title":"Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)","volume":"110","author":"Olsen","year":"2007","journal-title":"Blood"},{"key":"2025032702501669500_llae413-B10","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/ijlh.12954","article-title":"Evaluation of next-generation sequencing-based clonality analysis of T-cell receptor gamma gene rearrangements based on a new interpretation algorithm","volume":"41","author":"Nollet","year":"2019","journal-title":"Int J Lab Hematol"},{"key":"2025032702501669500_llae413-B11","doi-asserted-by":"crossref","article-title":"Party: a laboratory for recursive partitioning","author":"Hothorn","DOI":"10.32614\/CRAN.package.party"},{"key":"2025032702501669500_llae413-B12","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/S0161-5890(97)00130-2","article-title":"A Shannon entropy analysis of immunoglobulin and T cell receptor","volume":"34","author":"Stewart","year":"1997","journal-title":"Mol Immunol"},{"key":"2025032702501669500_llae413-B13","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/0092-8674(86)90388-0","article-title":"Diversity and rearrangement of the human T cell rearranging \u03b3 genes: nine germ-line variable genes belonging to two subgroups","volume":"45","author":"LeFranc","year":"1986","journal-title":"Cell"},{"key":"2025032702501669500_llae413-B14","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/0968-0004(89)90029-7","article-title":"The human T-cell receptor \u03b3 (TRG) genes","volume":"14","author":"Lefranc","year":"1989","journal-title":"Trends Biochem Sci"},{"key":"2025032702501669500_llae413-B15","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0190-9622(94)70231-4","article-title":"Localization of clonal T cells to the epidermis in cutaneous T-cell lymphoma","volume":"31","author":"Fivenson","year":"1994","journal-title":"J Am Acad Dermatol"},{"key":"2025032702501669500_llae413-B16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1038\/sj.leu.2404481","article-title":"Powerful strategy for polymerase chain reaction-based clonality assessment in T-cell malignancies Report of the BIOMED-2 Concerted Action BHM4 CT98-3936","volume":"21","author":"Bruggemann","year":"2007","journal-title":"Leukemia"},{"key":"2025032702501669500_llae413-B17","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1309\/AJCP5TYGBVW4ZITR","article-title":"A comparison of deep sequencing of TCRG rearrangements vs traditional capillary electrophoresis for assessment of clonality in T-cell lymphoproliferative disorders","volume":"141","author":"Schumacher","year":"2014","journal-title":"Am J Clin Pathol"},{"key":"2025032702501669500_llae413-B18","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jaad.2015.04.030","article-title":"T-cell clonality assessment by next-generation sequencing improves detection sensitivity in mycosis fungoides","volume":"73","author":"Sufficool","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"2025032702501669500_llae413-B19","doi-asserted-by":"crossref","first-page":"3369","DOI":"10.1182\/blood.V100.9.3369","article-title":"Clonal heterogeneity in mycosis fungoides and its relationship to clinical course","volume":"100","author":"Vega","year":"2002","journal-title":"Blood"},{"key":"2025032702501669500_llae413-B20","doi-asserted-by":"crossref","first-page":"3073","DOI":"10.1002\/eji.201242517","article-title":"Next generation sequencing for TCR repertoire profiling: platform-specific \u00adfeatures and correction algorithms","volume":"42","author":"Bolotin","year":"2012","journal-title":"Eur J Immunol"},{"key":"2025032702501669500_llae413-B21","doi-asserted-by":"crossref","first-page":"4099","DOI":"10.1182\/blood-2009-04-217604","article-title":"Comprehensive assessment of T-cell receptor \u03b2-chain diversity in \u03b1\u03b2 T cells","volume":"114","author":"Robins","year":"2009","journal-title":"Blood"},{"key":"2025032702501669500_llae413-B22","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.jaad.2005.08.057","article-title":"Defining early mycosis fungoides","volume":"53","author":"Pimpinelli","year":"2005","journal-title":"J Am Acad Dermatol"},{"key":"2025032702501669500_llae413-B23","doi-asserted-by":"crossref","first-page":"8081","DOI":"10.1038\/ncomms9081","article-title":"High-resolution analysis of the human T-cell receptor repertoire","volume":"6","author":"Ruggiero","year":"2015","journal-title":"Nat Commun"},{"key":"2025032702501669500_llae413-B24","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13000-020-01022-x","article-title":"Cutaneous T-cell lymphomas with pathogenic somatic mutations and absence of detectable clonal T-cell receptor gene rearrangement: two case reports","volume":"15","author":"Rojansky","year":"2020","journal-title":"Diagn Pathol"},{"key":"2025032702501669500_llae413-B25","doi-asserted-by":"crossref","first-page":"308ra158","DOI":"10.1126\/scitranslmed.aaa9122","article-title":"TCR sequencing facilitates diagnosis and identifies mature T cells as the cell of origin in CTCL","volume":"7","author":"Kirsch","year":"2015","journal-title":"Sci Transl Med"},{"key":"2025032702501669500_llae413-B26","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/path.1711740402","article-title":"Recombination pattern of the TCR \u03b3 locus in human peripheral T-cell lymphomas","volume":"174","author":"Theodorou","year":"1994","journal-title":"J\u00a0Pathol"},{"key":"2025032702501669500_llae413-B27","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S1525-1578(10)60456-4","article-title":"The distribution of gene segments in T-cell receptor \u03b3 gene rearrangements demonstrates the need for multiple primer sets","volume":"5","author":"Lawnicki","year":"2003","journal-title":"J Mol Diagn"},{"key":"2025032702501669500_llae413-B28","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2353\/jmoldx.2007.060087","article-title":"Analysis of T-cell receptor-\u00adgamma gene rearrangements using oligonucleotide microchip: a novel approach for the determination of T-cell clonality","volume":"9","author":"Gra","year":"2007","journal-title":"J\u00a0Mol Diagn"},{"key":"2025032702501669500_llae413-B29","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1136\/jclinpath-2018-205324","article-title":"Specific TCR gene rearrangements in mycosis fungoides: does advanced clinical stage show a preference?","volume":"71","author":"Marks","year":"2018","journal-title":"J Clin Pathol"},{"key":"2025032702501669500_llae413-B30","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/jdv.18852","article-title":"Identifying unmet needs and challenges in the definition of a plaque in mycosis fungoides: an EORTC-CLTG\/ISCL survey","volume":"37","author":"Quaglino","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llae413\/60455983\/llae413.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/4\/788\/60455983\/llae413.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/50\/4\/788\/60455983\/llae413.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T04:34:10Z","timestamp":1743309250000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/50\/4\/788\/7879572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,11,6]]},"published-print":{"date-parts":[[2025,3,26]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llae413","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2024,11,6]]}}}