Article Text

Download PDFPDF
A parallel comparison of T-cell clonality assessment between an in-house PCR assay and the BIOMED-2 assay leading to an efficient and cost-effective strategy
  1. Szu-Yin Kuo1,
  2. Hongxiang Liu2,
  3. Yung-Liang Liao1,
  4. Sheng-Tsung Chang1,
  5. Yen-Chuan Hsieh1,
  6. Betty Angela Nuako Bandoh2,
  7. Ming-Qing Du2,
  8. Shih-Sung Chuang1,3
  1. 1Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
  2. 2Department of Histopathology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
  3. 3Department of Pathology, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Shih-Sung Chuang, Department of Pathology, Chi-Mei Medical Center, 901 Chung-Hwa Road, Yung-Kang City, Tainan County, Taiwan 710; cmh5301{at}


Aims Diagnosis of T-cell lymphoproliferation is sometimes challenging, and in certain instances pathologists rely heavily on the clonality assessment results of T-cell receptor (TCR) gene rearrangement (TCR-GR). Many investigators have designed various in-house primer sets for PCR-based study targeting different loci of TCR genes. In recent years, the commercial BIOMED-2 protocols have become available. The in-house primers are very cheap while the BIOMED-2 primers are expensive. This parallel study aimed to compare the sensitivity of the in-house TCRG primers (two reactions) and the BIOMED-2 TCR primers (six reactions) in an attempt to develop a sensitive and cost-effective strategy for TCR-GR assessment.

Methods PCR-based analysis was performed on 69 samples of T-lineage neoplasms including 60 formalin-fixed paraffin-embedded (FFPE) tissues, 5 samples from peripheral blood (PB) and 4 samples from bone marrow (BM) aspirate.

Results Forty-seven (78%) FFPE and all PB or BM aspirate samples yielded control DNA products suitable for clonality assessment including 4 precursor and 50 mature T-cell neoplasms. The detection rates of clonal TCR-GR were 63% (34/54) by the two in-house TCRG primers, 85% (46/54) by all six BIOMED-2 reactions, 91% (49/54) by combining the in-house and BIOMED-2 TCRG reactions and 94% (51/54) by combining the in-house and all BIOMED-2 reactions. By using the in-house and BIOMED-2 TCRG reactions with a total of four tubes, clonal TCR-GR was detected in 91% of the cases. The reagent cost for this combination was one-third of that for the six BIOMED-2 reactions and the detection rate was also higher than the latter alone (91% vs 85%).

Conclusions As the in-house primers were custom made and are much cheaper than the commercial kits, the authors concluded that this four-tube strategy was cost-effective and efficient for TCR-GR clonality assessment.

  • Clonality
  • gene rearrangement
  • non-Hodgkin's lymphoma
  • T-cell lymphoma
  • t-cell receptor
  • Taiwan
  • lymphoma
  • molecular pathology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This study was supported by research grants from Chi-Mei Medical Center (CMFHR9913), Tainan, and National Science Council (97-2320-B-384-001-MY3), Taipei, Taiwan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Chi-Mei Medical Center, Tainan, Taiwan.

  • Provenance and peer review Not commissioned; externally peer reviewed.