Evaluation of epithelial cell proliferating activity and fibroblast nuclear kariometry in recurrent pterygium treated with mitomycin C.
OBJECTIVE
To evaluate the effectiveness of mitomycin C (MMC) in preventing recurrence of pterygium following conjunctival autograft transplantation (CAT). Ki-67 antigen to evaluate epithelial cell proliferation and fibroblast nuclear kariometry were used to assist treatment evaluation.


METHODS
Twenty-nine patients with recurrent pterygium were divided into three groups: Group (G) 1--CAT and placebo eyedrops (PED); G2--CAT, 0.015% MMC subconjunctivally, and PED; G3--CAT and 0.02% MMC eyedrops. Immunohistochemistry for the Ki-67 antigen and fibroblast nuclei kariometry were performed on the excised tissue, divided into nasal and temporal sides. Kariometry was evaluated in terms of volume (Vl) and area (Ar) using at least 50 cells/patient.


RESULTS
The percentage of positive epithelial cells for the Ki-67 antigen on the nasal and temporal side after treatment of the three groups were: nasal (5.39% G1, 4.49% G2, and 3.88% G3); temporal (3.30% G1, 4.46% G2, 4.14% G3), did not show significant differences. Fibroblast nucleus kariometry was: nasal Vl (792.1 mu3 G1, 605.1 mu3 G2, and 549.9 mu3 G3) and Ar (100.58 mu2 G1, 83.13 mu2 G2, and 78.41 mu2 G3). The three groups showed significant differences: p=0.039 and p=0.035, for respectively Vl and Ar, on the nasal side. After a six month of treatment, the three groups presented the following recurrence rates: G1, 22.22%, G2, 18.18% and G3, 33.33%, respectively.


CONCLUSIONS
MMC did not reduce the number of positive epithelial cells for the Ki-67 antigen in recurrent pterygium, but decreased fibroblast nucleus volume and area on the nasal side of the pterygia. The number of positive epithelial cells for the Ki-67 antigen seemed not to be related to pterygium recurrence observed over a six-month post-surgery period. The role of epithelial cell proliferation in pterygium recurrence should be evaluated by further studies.
Almeida Junior
Gildasio Castello de
GC
Departamento de Oftalmologia, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil. gcaj@uol.com.br
Frederico
Fabio Batista
FB
Watanabe
Karina Paula
KP
Garcia
Tatiana Vanucci
TV
Iquejiri
Angela Yuri
AY
Cury
Patrícia Maluf
PM
Taboga
Sebastião Roberto
SR
Azoubel
Reinaldo
R
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D049109:Cell Proliferation / Q000187:drug effects; D003228:Conjunctiva / Q000166:cytology / Q000637:transplantation*; D016039:Corneal Transplantation; D004847:Epithelial Cells / Q000166:cytology / Q000187:drug effects; D005346:Fibroblast Growth Factors / Q000032:analysis; D006801:Humans; D007620:Karyometry; D019394:Ki-67 Antigen / Q000032:analysis; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D011625:Pterygium / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control*; D055502:Secondary Prevention; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D019394:Ki-67 Antigen; D009883:Ophthalmic Solutions; D018809:Proliferating Cell Nuclear Antigen; D016685:Mitomycin; D005346:Fibroblast Growth Factors