TY - JOUR
T1 - The Diagnostic Value of Exfoliative Cytology vs Histopathology for Ocular Surface Squamous Neoplasia
AU - Semenova, Ekaterina A.
AU - Milman, Tatyana
AU - Finger, Paul T.
AU - Natesh, Sribhargava
AU - Kurli, Madhavi
AU - Schneider, Susan
AU - Iacob, Codrin E.
AU - McCormick, Steven A.
N1 - Funding Information:
This study was supported by The EyeCare Foundation Inc, New York, New York (Drs Kurli and Finger); The New York Eye and Ear Infirmary Pathology Research Fund, New York, New York (Drs Milman, Schneider, Iacob, and McCormick); and the International Council of Ophthalmology Foundation, San Francisco, California (Drs Semenova and Natesh). The authors indicate no financial conflict of interest. Involved in design of study (E.A.S., T.M., M.K., S.N., C.E.I., S.A.M., P.T.F.); conduct of study (T.M., M.K., S.N., C.E.I., S.A.M., P.T.F.); collection, management, analysis, and interpretation of data (E.A.S., T.M., M.K., S.S., S.N., C.E.I., P.T.F.); and preparation, review, or approval of the manuscript (E.A.S., T.M., S.N., C.E.I., S.A.M., P.T.F.). The Institutional Review Board and Ethics Committees of The New York Eye Cancer Center granted approval for this research. This study adhered to the Declaration of Helsinki and Health Insurance Portability and Accountability Act of 1996.
PY - 2009/11
Y1 - 2009/11
N2 - Purpose: To determine the reliability and role of conjunctival exfoliative cytologic and histopathologic diagnosis of biopsied tissue in ocular surface squamous neoplasia. Design: 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.
AB - Purpose: To determine the reliability and role of conjunctival exfoliative cytologic and histopathologic diagnosis of biopsied tissue in ocular surface squamous neoplasia. Design: 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.
UR - http://www.scopus.com/inward/record.url?scp=70350564797&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2009.06.015
DO - 10.1016/j.ajo.2009.06.015
M3 - Article
C2 - 19660734
AN - SCOPUS:70350564797
SN - 0002-9394
VL - 148
SP - 772-778.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -