title: The diagnostic value of exfoliative cytology vs histopathology for ocular surface squamous neoplasia.
abstract: OBJECTIVE
  To determine the reliability and role of conjunctival exfoliative cytologic and histopathologic diagnosis of biopsied tissue in ocular surface squamous neoplasia.
  
  
  METHODS
  Retrospective review of an interventional case series of patients biopsied and treated for squamous conjunctival and corneal neoplasia.
  
  
  METHODS
  Forty-nine patients who underwent conjunctival cytologic analysis (n = 36), conjunctival biopsy (n = 35), or both were evaluated. For the purposes of this study, three ocular pathologists reviewed the results of cytologic and biopsied tissue in a masked fashion.
  
  
  RESULTS
  Evaluation of cytologic smears revealed a 91% concordance in interpretation of conjunctival cytologic material as no dysplasia vs dysplasia. The concordance dropped to 59% in grading the degree of dysplasia. The cytologic material was found to be inadequate for interpretation in 1 case. Evaluation of subsequent biopsy revealed a 98% concordance between the pathologists in interpretation of biopsied tissue as no dysplasia vs any degree of dysplasia. The concordance decreased to 83% in grading the degree of dysplasia. Cytologic evaluation was capable of distinguishing a neoplastic from nonneoplastic process before tissue biopsy in 80% of cases.
  
  
  CONCLUSIONS
  Ocular surface cytologic analysis is a simple, safe, and relatively noninvasive diagnostic tool. It was found helpful in detecting dysplasia before surgical resection. It was used in the settings of recurrent tumor and for follow-up care of patients treated with topical chemotherapy. Although cytologic smears cannot replace incisional or excisional biopsy for definitive diagnosis, exfoliative cytologic analysis can play an important role in the diagnosis and management of patients with ocular surface squamous neoplasia.
authors: The New York Eye Cancer Center, New York, NY 10065, USA.
authors: Ekaterina A
authors: EA
authors: Semenova
authors: Tatyana
authors: T
authors: Milman
authors: Paul T
authors: PT
authors: Finger
authors: Sribhargava
authors: S
authors: Natesh
authors: Madhavi
authors: M
authors: Kurli
authors: Susan
authors: S
authors: Schneider
authors: Codrin E
authors: CE
authors: Iacob
authors: Steven A
authors: SA
authors: McCormick
mesh_terms: D000368:Aged; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003228:Conjunctiva / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000175:diagnosis*; D003316:Corneal Diseases / Q000175:diagnosis*; D003584:Cytological Techniques; D005134:Eye Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012189:Retrospective Studies