Abstract
Purpose :
In situ hybridization provides a reliable method to detect human papillomavirus (HPV) infection, and at sites outside the eye can help to differentiate benign or low grade lesions from those with greater malignant potential. We performed a retrospective chart review to evaluate the role of HPV infections in conjunctival papilloma, conjunctival intraepithelial neoplasia (CIN), and conjunctival carcinoma in situ (CIS).
Methods :
Review of institutional pathology records identified patients with a conjunctival papilloma, CIN, or CIS in which in situ hybridization was performed to detect HPV at initial diagnosis. Cases prior to 2015 were analyzed using DNA in situ hybridization (DISH), while those from 2015 onwards were analyzed using RNA in situ hybridization (RISH). The low risk HPV assay detects types 6 and 11, while the high risk assay detects HPV 16 and 18 along with additional types.
Results :
Of the 46 patients in our study, 16 males and 15 females were diagnosed with conjunctival papilloma (ages 9-86, mean 42), while 8 males and 7 females were diagnosed with either CIN or CIS (ages 51-89, mean 67). Low risk HPV was identified in 24 of the 29 conjunctival papilloma tested (83%). This included 16/17 positive by RISH, and 8/12 positive by DISH. In contrast, none of the CIN/CIS cases tested were positive for low risk HPV. Only one papilloma was positive for high risk HPV, and this lesion also showed moderate to severe epithelial dysplasia. Of the two other papilloma with dysplasia, one was positive for low risk HPV and the other was negative for HPV. Among the 15 CIN/CIS cases tested, including 5 by DISH and 10 by RISH, only one was positive for high risk HPV. HPV status was not clearly linked to tumor recurrence, but a lack of long term follow up in many cases limited this analysis.
Conclusions :
This study suggests that transcriptionally active low risk HPV is commonly present in conjunctival papilloma, and that RISH may be a more sensitive assay than DISH. In contrast, high risk HPV is rare in conjunctival epithelial lesions, but may promote dysplastic changes in some papilloma.
This is a 2020 ARVO Annual Meeting abstract.