Cytologic and DNA cytometric diagnosis and therapy monitoring of squamous cell carcinoma in situ and malignant melanoma of the cornea and conjunctiva

OBJECTIVE: To investigate the diagnostic accuracy of exfoliative cytology o f the cornea and conjunctiva and DNA image cytometry for quality control an d monitoring of therapy for malignant neoplasms. STUDY DESIGN: Conjunctival or corneal smears from six cases clinically susp icious for malignant melanomas and eight suspicious for carcinomas in situ were investigated. Smears from 18 cases clinically nonsuspicious for neopla stic diseases served as negative controls. Repeated smears were obtained du ring and after local mitomycin C (MMC) therapy. RESULTS: In none of 18 nonsuspicious cases, cytology revealed abnormal cell s. DNA cytometry showed non-aneuploidy in all of these. All smears from pat ients with histologically proven malignant melanomas (MM) and squamous cell carcinomas in situ revealed abnormal cells, Image cytometry demonstrated D NA aneuploidy in 66.6% of patients with MM and 80% with carcinoma. Sensitiv ity of cytology thus tons 100% for both MM and carcinoma; specificity also was 100%. DNA measurement ts after MMC therapy revealed euploid polyploidiz ation of nonneoplastic squamous cells. DNA cytometry provided an objective identification of tumor cell regression. CONCLUSION: Cytologic examination of corneal and conjunctival smears is a n oninvasive tool with high diagnostic accuracy for detection of epithelial n eoplasms. DNA image cytometry can serve for quality control and for objecti ve monitoring of the effect of local chemotherapy.