Cytologic and DNA cytometric diagnosis and therapy monitoring of squamous cell carcinoma in situ and malignant melanoma of the cornea and conjunctiva.
OBJECTIVE
To investigate the diagnostic accuracy of exfoliative cytology of the cornea and conjunctiva and DNA image cytometry for quality control and monitoring of therapy for malignant neoplasms.


METHODS
Conjunctival or corneal smears from six cases clinically suspicious for malignant melanomas and eight suspicious for carcinomas in situ were investigated. Smears from 18 cases clinically nonsuspicious for neoplastic diseases served as negative controls. Repeated smears were obtained during and after local mitomycin C (MMC) therapy.


RESULTS
In none of 18 nonsuspicious cases, cytology revealed abnormal cells. DNA cytometry showed nonaneuploidy in all of these. All smears from patients with histologically proven malignant melanomas (MM) and squamous cell carcinomas in situ revealed abnormal cells. Image cytometry demonstrated DNA aneuploidy in 66.6% of patients with MM and 80% with carcinoma. Sensitivity of cytology thus was 100% for both MM and carcinoma; specificity also was 100%. DNA measurements after MMC therapy revealed euploid polyploidization of nonneoplastic squamous cells. DNA cytometry provided an objective identification of tumor cell regression.


CONCLUSIONS
Cytologic examination of corneal and conjunctival smears is a noninvasive tool with high diagnostic accuracy for detection of epithelial neoplasms. DNA image cytometry can serve for quality control and for objective monitoring of the effect of local chemotherapy.
Nadjari
B
B
Institute of Cytopathology, Heinrich Heine University, Düsseldorf, Germany.
Kersten
A
A
Ross
B
B
Motherby
H
H
Krallmann
R
R
Sundmacher
R
R
Böcking
A
A
D000782:Aneuploidy; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D003316:Corneal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D004273:DNA, Neoplasm / Q000032:analysis*; D005069:Evaluation Studies as Topic; D006801:Humans; D019044:Image Cytometry / Q000379:methods; D007091:Image Processing, Computer-Assisted; D008545:Melanoma / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D016685:Mitomycin / Q000627:therapeutic use; D011003:Ploidies; D012680:Sensitivity and Specificity
D000903:Antibiotics, Antineoplastic; D004273:DNA, Neoplasm; D016685:Mitomycin