Significance of acellular smears in conjunctival impression cytology.
OBJECTIVE
Conjunctival xerosis is a marker for vitamin A deficiency. Conjunctival impression cytology (CIC) is a widely used technique to detect xerosis in field studies. Inadequate and acellular samples are generally considered technical failures and are treated as uninterpretable. The purpose of this study is to determine the significance of acellular smears in the detection of vitamin A deficiency.


METHODS
CIC with transfer (CICT) and blood samples were collected from freshly diagnosed cancer patients and healthy controls. CICT smears were classified as cellular or acellular. Serum vitamin A levels were tested by high-performance liquid chromatography. CICT results were compared with vitamin A levels.


RESULTS
CICT was collected from 1,694 subjects. There were 118 (7%) acellular smears, i.e. 99 in patients and 19 in controls. Serum vitamin A levels were available in 112 of these subjects. Levels <20 µg/dl were seen in 82.1% of the subjects with acellular smears and in 18.9% of the subjects with cellular smears (p < 0.001). Of the gastrointestinal and hepatobiliary and hematologic cancers, 15.6% and 10.5% showed acellular smears, respectively.


CONCLUSIONS
Acellular smears in conjunctival imprint cytology may indicate hypovitaminosis A, provided technical failure to obtain cellularity is ruled out.
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India.
Padmini
P
Chaparala
Aruna Kumari
AK
Prayaga
Raghunadha Rao
RR
Digumarti
D001661:Biliary Tract Neoplasms / Q000150:complications; D002851:Chromatography, High Pressure Liquid; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications; D012680:Sensitivity and Specificity; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis*
D014801:Vitamin A