title: Association of Epithelial Atypia With Recurrence After Surgical Excision in Conjunctival Papilloma.
abstract: OBJECTIVE
  To investigate the association between recurrence of conjunctival papillomas and presence of atypical epithelial changes in patients undergoing surgical excision for conjunctival papilloma.
  
  
  METHODS
  We retrospectively reviewed 1,195 ophthalmic pathology specimens from 2004 to 2014 at Ichikawa General Hospital. Pathologic specimens of 5 patients with a final diagnosis of "conjunctival papilloma" were stained with hematoxylin-eosin, Ki 67, p53, human papillomavirus (HPV) 16 and 18 antibodies.
  
  
  RESULTS
  Of 1,195 patients, 5 patients (4 men, 1 woman; age range: 27∼57 years, mean age: 38.4 years) had a diagnosis of conjunctival papilloma, which constituted to 0.42% of the pathologic diagnosis made for the ophthalmology specimens. All specimens displayed multiple fronds of thickened conjunctival epithelium that enclosed cores of vascularized connective tissues. Three patients with recurrence after surgical excision demonstrated moderate to severe epithelial atypia, who also showed higher staining with Ki67 and p53 compared with patients with no recurrence. HPV16 and 18 antibodies staining did not appear to relate to recurrences.
  
  
  CONCLUSIONS
  Conjunctival papillomas with higher positive staining for Ki67 and p53 seem to have a higher risk of recurrence even after complete surgical excision and necessitate careful follow-up.
authors.affiliation: Departments of Ophthalmology (H.Y., M.D., T.Y., S.D., Y.S., J.S.), and Pathology and Laboratory Medicine (J.M., Y.T.), Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan; and Department of Ophthalmology (H.Y., M.D., K.T.), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yazu
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Jun
authors.initials: J
authors.lastname: Miyauchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Takefumi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Seika
authors.initials: S
authors.lastname: Den
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D000328:Adult; D003228:Conjunctiva / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010212:Papilloma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53