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Kato JM, Ballalai PL, de Lima PP, Santo RM. Efficacy and safety of topical 0.5% 5-Fluorouracil as primary treatment of ocular surface squamous neoplasia. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e510-e514. [PMID: 38631493 DOI: 10.1016/j.jcjo.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/23/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To assess the efficacy and safety of topical 0.5% 5-Fluorouracil (5-FU) as a primary therapy of ocular surface squamous neoplasia (OSSN). DESIGN Retrospective study. PARTICIPANTS Patients with clinically suspected OSSN referred to a Brazilian tertiary health center between October 2015 and December 2022. METHODS After diagnostic confirmation of OSSN with exfoliative cytology, 0.5% 5-FU was administered topically 4 times daily for 2 weeks followed by a pause of 2 weeks. RESULTS A total of 54 patients were included in this study, 32 males (59.3%), mean age of 62.9 years old. Complete resolution of OSSN was achieved in 70.4%. The median number of cycles was 2 (range 1-5). Side effects were reported in 35.2%, which included eyelid erythema, conjunctival hyperemia, and punctal stenosis. None of the patients stopped treatment due to adverse effects. Patients who had partial response to 0.5% 5-FU had complementary treatment with surgery, Mitomycin-C and/or Interferon ⍺2b. Overall recurrence was 14.8%. Median follow-up was 14 months (range 2-92 months). In a multivariate Cox regression analysis, the risk of relapse was 84% lower in patients who had complete response to 0.5% 5-FU (p = 0.018). CONCLUSION Topical 0.5% 5-FU may be considered a safe and effective primary therapy for OSSN, with a low rate of side effects.
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Affiliation(s)
- Juliana Mika Kato
- Hospital das Clínicas HC-FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil..
| | - Priscilla Luppi Ballalai
- Hospital das Clínicas HC-FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Ruth Miyuki Santo
- Hospital das Clínicas HC-FMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Yu P, Chen W, Ge L, Fang J, Huang X, Tong H, Chen Z, Ding C, Huang Y. Logic gate-driven dual-index balanced visualization strategy for tumor metastasis diagnosis. Biosens Bioelectron 2023; 237:115556. [PMID: 37536227 DOI: 10.1016/j.bios.2023.115556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
Exfoliated tumor cells are integral to malignant tumors diagnosis. The process of clinical cytology of exfoliation involves several complex steps that require at least two days of preparation. Here, we develop a balanced-etching visual kit based on concentration differences of Glutathione/Glucose (GSH/Glu) to distinguish normal from exfoliated tumor cells rapidly and accurately. The balanced-etching visualization kit can be used to obtain color cards and screen exfoliated tumor cells initially (within 10 min). Furthermore, by utilizing logic gates and machine learning algorithms for RGB extraction of the color card obtained from the kit, accurate screening of exfoliated tumor cells is achieved. Finally, a series of clinical tumor samples, such as urine, pleural fluids, ascites, and gastric fluids, have been validated. With effective experimental methods, accurate disease information, and appropriate therapeutic programs, the novel diagnostic strategy is expected to promote precision medicine.
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Affiliation(s)
- Pengfei Yu
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Department of Gastric Surgery, Hangzhou, Zhejiang, 310022, China
| | - Weiwei Chen
- Hangzhou Normal University, College of Material Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou, Zhejiang, 311121, China
| | - Li Ge
- Hangzhou Normal University, College of Material Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou, Zhejiang, 311121, China; Zhengjiang Zhongwei Medical Research Center, Department of Research and Development, Hangzhou, Zhejiang, 310020, China.
| | - Jingquan Fang
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Department of Gastric Surgery, Hangzhou, Zhejiang, 310022, China
| | - Xingmao Huang
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Department of Gastric Surgery, Hangzhou, Zhejiang, 310022, China
| | - Hui Tong
- Zhengjiang Zhongwei Medical Research Center, Department of Research and Development, Hangzhou, Zhejiang, 310020, China
| | - Zikang Chen
- Hangzhou Normal University, College of Material Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou, Zhejiang, 311121, China
| | - Caiping Ding
- Hangzhou Normal University, College of Material Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou, Zhejiang, 311121, China.
| | - Youju Huang
- Hangzhou Normal University, College of Material Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou, Zhejiang, 311121, China.
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Shahraki K, Shahraki K, Ghasemi Boroumand P, Sheervalilou R. Promotor methylation in ocular surface squamous neoplasia development: epigenetics implications in molecular diagnosis. Expert Rev Mol Diagn 2023; 23:753-769. [PMID: 37493058 DOI: 10.1080/14737159.2023.2240238] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Cancer is heavily influenced by epigenetic mechanisms that include DNA methylation, histone modifications, and non-coding RNA. A considerable proportion of human malignancies are believed to be associated with global DNA hypomethylation, with localized hypermethylation at promoters of certain genes. AREA COVERED The present review aims to emphasize on recent investigations on the epigenetic landscape of ocular surface squamous neoplasia, that could be targeted/explored using novel approaches such as personalized medicine. EXPERT OPINION While the former is thought to contribute to genomic instability, promoter-specific hypermethylation might facilitate tumorigenesis by silencing tumor suppressor genes. Ocular surface squamous neoplasia, the most prevalent type of ocular surface malignancy, is suggested to be affected by epigenetic mechanisms, as well. Although the exact role of epigenetics in ocular surface squamous neoplasia has mostly been unexplored, recent findings have greatly contributed to our understanding regarding this pathology of the eye.
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Affiliation(s)
- Kourosh Shahraki
- Ocular Tissue Engineering Research Center, Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Kianoush Shahraki
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
- Cornea Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Paria Ghasemi Boroumand
- ENT, Head and Neck Research Center and Department, Iran University of Medical Science, Tehran, Iran
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Shawaf T, Hussen J. Cytological and microbiological evaluation of conjunctiva in camels with and without conjunctivitis. Vet Ophthalmol 2023; 26:39-45. [PMID: 35657141 DOI: 10.1111/vop.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/11/2022] [Accepted: 05/24/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To describe the cytological analysis of conjunctiva from normal camels and camels with bacterial conjunctivitis. ANIMALS STUDIED This study was conducted on 7 normal camels and 15 camels affected with conjunctivitis. The affected camels had a history of conjunctivitis with signs including chemosis, blepharospasm, frequent blinking, and mild-to-moderate serous, mucoid, or purulent ocular discharge. PROCEDURES Bacterial swabs were collected from the inferior conjunctival sac of the affected eye without topical anesthetics. Conjunctival smears were obtained from the conjunctival surface for cytological analysis. RESULTS The cellular analysis of ocular smears revealed a higher percentage of basal cells, neutrophils, eosinophils, and macrophages in camels with conjunctivitis compared with normal camels. In contrast to this, smears from normal camels showed an increased percentage of superficial epithelial cells compared with affected camels. The microbiological assessment of conjunctival swabs collected from affected animals identified a bacterial growth of Staphylococcus aureus., Bacillus sp., Streptococcus sp., Enterococcus faecium., Staphylococcus sp., Corynebacterium sp., Coryne pseudotuberculosis., Saprophytica, Enterobacter cloacae, Escherichia coli, Proteus mirabilis, Proteus vulagaris, and Pseudomonas aeruginosa. CONCLUSIONS It was observed that bacterial conjunctivitis in camels was associated with increased percentages of basal epithelial cells, neutrophils, eosinophils, and macrophages compared with normal camels, while normal camels showed an increased percentage of superficial epithelial cells compared with affected camels.
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Affiliation(s)
- Turke Shawaf
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Jamal Hussen
- Department of Microbiology, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
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Yeoh CHY, Lee JJR, Lim BXH, Sundar G, Mehta JS, Chan ASY, Lim DKA, Watson SL, Honavar SG, Manotosh R, Lim CHL. The Management of Ocular Surface Squamous Neoplasia (OSSN). Int J Mol Sci 2022; 24:ijms24010713. [PMID: 36614155 PMCID: PMC9821412 DOI: 10.3390/ijms24010713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
The rise of primary topical monotherapy with chemotherapeutic drugs and immunomodulatory agents represents an increasing recognition of the medical management of ocular surface squamous neoplasia (OSSN), which may replace surgery as the standard of care in the future. Currently, there is no consensus regarding the best way to manage OSSN with no existing guidelines to date. This paper seeks to evaluate evidence surrounding available treatment modalities and proposes an approach to management. The approach will guide ophthalmologists in selecting the most appropriate treatment regime based on patient and disease factors to minimize treatment related morbidity and improve OSSN control. Further work can be done to validate this algorithm and to develop formal guidelines to direct the management of OSSN.
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Affiliation(s)
- Clarice H. Y. Yeoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jerome J. R. Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
| | - Blanche X. H. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Gangadhara Sundar
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Jodhbir S. Mehta
- Duke-NUS Graduate Medical School, Singapore 169857, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Singapore National Eye Centre, Singapore 168751, Singapore
| | - Anita S. Y. Chan
- Duke-NUS Graduate Medical School, Singapore 169857, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Singapore National Eye Centre, Singapore 168751, Singapore
- Histopathology, Pathology Department, Singapore General Hospital, Singapore 169608, Singapore
| | - Dawn K. A. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Stephanie L. Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, NSW 2000, Australia
| | | | - Ray Manotosh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Chris H. L. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence:
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Mastronikolis S, Adamopoulou M, Tsiambas E, Makri OΕ, Pagkalou M, Thomopoulou VK, Georgakopoulos CD. Vascular Endothelial Growth Factor expression patterns in non- Human Papillomavirus - related pterygia: an experimental study on cell spot arrays digital analysis. Curr Eye Res 2022; 47:1003-1008. [PMID: 35322737 DOI: 10.1080/02713683.2022.2058018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE The role of angiogenic factors -such as vascular endothelial growth factor (VEGF) - in development and progression of pterygia lesions remains under investigation. In the current study, we analyzed VEGF protein expression in a series of pterygia and normal conjunctiva epithelia. METHODS Using a liquid based cytology assay, thirty (n = 30) cell specimens were obtained by applying a smooth scraping on conjunctiva epithelia and fixed accordingly. None of them had a history of Human Papillomavirus (HPV) infection. Similarly, the same process was applied also in normal conjunctiva epithelia (n = 10; control group). We constructed five (n = 5) slides each containing eight (n = 8) cell spots. An immunocytochemistry (ICC) assay was implemented. Digital image analysis was also performed for evaluating objectively the corresponding immunostaining intensity levels. RESULTS All the examined pterygia cell samples over expressed the marker. High staining intensity levels were detected in 15/30 (50%), whereas the rest 15/30 (50%) demonstrated moderate expression. Overall VEGF expression was statistically significantly higher in pterygia compared to normal conjunctiva epithelia (p=.0001). Concerning the other parameters, VEGF protein expression did not associate with the gender of the patients (p = 0.518), the presence of recurrent lesion (p = 0.311), the anatomical location (p = 0.191) or with their morphology (p = 0.316). Interestingly, the recurrent lesions demonstrated the highest levels of VEGF expression. CONCLUSIONS VEGF over expression is a frequent event in pterygia playing a potentially central molecular role in the progression of the lesion. Cell spot array analysis -based on liquid cytology- seems to be an innovative, easy to use technique for analyzing a broad variety of molecules in multiple specimens on the same slide by applying different ICC assays.
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Affiliation(s)
| | - Maria Adamopoulou
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | | | - Olga Ε Makri
- Department of Ophthalmology, Medical School, University of Patras, Rion - Achaia, Greece
| | - Marina Pagkalou
- Department of Chemistry, University of Crete, Voutes - Heraklion, Greece
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Chalkia AK, Bontzos G, Spandidos DA, Detorakis ET. Human papillomavirus infection and ocular surface disease (Review). Int J Oncol 2019; 54:1503-1510. [PMID: 30896784 PMCID: PMC6438422 DOI: 10.3892/ijo.2019.4755] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/15/2019] [Indexed: 11/14/2022] Open
Abstract
Human papillomavirus (HPV) infection has been implicated as a primary cause of lesions in the anogenital region, skin, oropharynx and respiratory tract. Additionally, the role of HPV in the pathogenesis of ocular surface disease has also been extensively studied. Conjunctival papilloma development has been strongly associated with the HPV infection of certain subtypes. On the other hand, the role of HPV in conjunctival pterygium, conjunctival intraepithelial neoplasia (CIN) and ocular surface squamous neoplasia (OSSN) remains controversial. Genetic predisposition and environmental factor is important in HPV hosts as regards the pathogenesis of ocular surface disease. Several studies have indicate a synergic role of HPV with ultraviolet radiation in pterygium establishment. A higher recurrence risk rate and more aggressive disease of ophthalmic pterygium is observed in cases of HPV infection. The purpose of this review was to provide a systematic review of the literature and to assist in a better understanding of the role of HPV in ocular surface disease.
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Affiliation(s)
- Aikaterini K Chalkia
- Department of Ophthalmology, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Georgios Bontzos
- Department of Ophthalmology, Red Cross Hospital, 11526 Athens, Greece
| | - Demetrios A Spandidos
- Department of Virology, Medical School, University of Crete, 71110 Heraklion, Greece
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Cicinelli MV, Marchese A, Bandello F, Modorati G. Clinical Management of Ocular Surface Squamous Neoplasia: A Review of the Current Evidence. Ophthalmol Ther 2018; 7:247-262. [PMID: 30030703 PMCID: PMC6258579 DOI: 10.1007/s40123-018-0140-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Indexed: 12/24/2022] Open
Abstract
Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented malignancy of the ocular surface and is represented in a wide range of histologic diagnoses, ranging from mild epithelial dysplasia to invasive squamous carcinoma. Although surgical excision is still the gold standard for OSSN treatment, interest in conservative medical approaches is steadily growing. We have reviewed all of the literature on OSSN published in English in the MEDLINE database up to May 2018, using the keywords “ocular surface squamous neoplasia,” “squamous conjunctival carcinoma,” and “conjunctival carcinoma in situ,” with the aim to provide a comprehensive review of the most recent evidence on this distinct clinical entity.
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Affiliation(s)
- Maria Vittoria Cicinelli
- Oncology Unit, Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Alessandro Marchese
- Oncology Unit, Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Bandello
- Oncology Unit, Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giulio Modorati
- Oncology Unit, Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Milan, Italy
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