The diagnostic value of exfoliative cytology vs histopathology for ocular surface squamous neoplasia.
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.
Semenova
Ekaterina A
EA
The New York Eye Cancer Center, New York, NY 10065, USA.
Milman
Tatyana
T
Finger
Paul T
PT
Natesh
Sribhargava
S
Kurli
Madhavi
M
Schneider
Susan
S
Iacob
Codrin E
CE
McCormick
Steven A
SA
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