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Impressum
DNA Polyploidy following Topical Mitomycin C Chemotherapy and/or Radiation of Conjunctival Squamous Cell Carcinoma and Malignant Melanoma
1Cartsburg O., 1Kallen C., 1Sundmacher R., 2Pomjanski N., 2Böcking A.
1Dept. of Ophthalmology, 2Institute of Cytopathology, Heinrich-Heine- University, Moorenstr. 5, D-40225 Düsseldorf, Germany
Introduction: Non-neoplastic epithelial changes often occur following
treatment of premalignant or malignant conjunctival neoplasm by means
of topical Mitomycin C (MMC) and radiation. These reactive alterations
of the conjunctival epithelium can be a differential diagnostic challenge.
Our aim was to investigate changes in nuclear distribution of DNA of benign
conjunctival epithelial cells after MMC- and radiation therapy by DNA-image-cytometry.
Methods: Conjunctival brush smears were taken from 13 patients
(13 eyes) with squamous cell carcinomas and six patients (6 eyes) with
conjunctival malignant melanomas in situ treated with MMC-drops (0.02%
or 0.04%) alone (n=12), with radiation therapy (n=3) or in combination
(n=4) each before, during and after treatment. At first the obtained brush
smears were evaluated by cytology. After Feulgen restaining, the DNA content
of reactivly changed cells was determined using the AutoCyte-QUIC-DNA®
workstation.
Results: Euploid DNA-polyploidism and morphological features were
considered as therapeutic response. This was seen in all cases (19/19).
Four patients showed their greatest DNA-stemline at 4c and 15 patients
at 8c. This therapeutical effect was observed during and following MMC-drops
and/or radiation and remained stable in 94% after mean follow-up of 22.5
months (SD 15.4). In five patients image cytometry additionally demonstrated
DNAstemline aneuploidy as evidence of tumour recurrence.
Conclusion: Measurements of DNA-content revealed euploid polyploidization
of suspicious but benign squammous cells which is the biologic correlate
of the well known secondary morphologic changes following topical chemotherapy
and/or radiation. DNA image cytometry helps to identify euploid polyploidization
as reactive changes and clearly differentiate this from recurrent carcinoma.