Use of impression cytology for the detection of unsuspected ocular surface squamous neoplasia cells in pterygia

Purpose: To evaluate the agreement between the methodologies of impression cytology (IC) and histopathology regarding epithelial lesions clinically diagnosed as pterygium and also regarding the detection of unsuspected and associated ocular surface squamous neoplasia (OSSN). Methods: Thirty-two Brazilian patients were included and IC was performed on all pterygia before excision. Histopathogical examination was considered the gold standard and was performed by two experienced ocular pathologists in which consensus existed regarding pterygia diagnosis. IC accuracy was assessed by sensitivity and specificity with a 95% confidence interval. Results: From the 32 primary lesions studied, histopathological examination confirmed the diagnosis of pterygium without atypical cells in 19 cases (60%) and showed unsuspected and associated OSSN cells in 13 cases (40%). IC demonstrated one false-negative and one false-positive result for atypia. Statistical analysis showed an estimated sensitivity of 92%, specificity of 94%, positive predictive value of 92%, and negative predictive value of 94%. Conclusion: IC demonstrated high agreement with histopathological analysis in the detection of atypical epithelial cells in unsuspected OSSN in Brazilian pterygia patients.

研究目的：评估印迹细胞学（impression cytology, IC）与组织病理学（histopathology）两种方法，在临床诊断为翼状胬肉（pterygium）的上皮病变检测，以及意外发现并关联的眼表鳞状上皮肿瘤（ocular surface squamous neoplasia, OSSN）检测方面的一致性。
研究方法：纳入32名巴西患者，所有待切除翼状胬肉均于术前实施印迹细胞学检测。以组织病理学检查作为金标准，由两名经验丰富的眼科病理学家阅片，二者就翼状胬肉的诊断达成共识。采用灵敏度、特异度及95%置信区间评估印迹细胞学的诊断准确性。
研究结果：在所纳入的32例原发性病变中，组织病理学检查证实19例（60%）为无异型细胞的翼状胬肉，13例（40%）检出意外发现并关联的眼表鳞状上皮肿瘤细胞。印迹细胞学检测发现1例假阴性、1例假阳性异型细胞结果。统计学分析显示，其灵敏度约为92%，特异度为94%，阳性预测值为92%，阴性预测值为94%。
研究结论：在巴西翼状胬肉患者中，印迹细胞学与组织病理学分析在检测意外发现的眼表鳞状上皮肿瘤相关异型上皮细胞方面，表现出较高的一致性。