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Ye Ji Kim, Chau Miu, Carla Carrilho, Yu-Tsueng Liu, Robert Schooley, Jonathan H Lin; Ocular Surface Squamous Neoplasms in 75 HIV+ Mozambicans. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4661.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular surface squamous neoplasia (OSSN) arises from malignant transformation of the keratinocytes within the squamous epithelia of the conjunctiva and cornea, the anterior ocular surface tissues. OSSN is more common in HIV infected populations. HIV infection also significantly increases the risk for developing human papillomavirus (HPV)-related carcinomas. HPV, especially the high-risk HPV16 and HPV18 genotypes, causes squamous cell dysplasia and carcinoma arising from cervix, head, and neck squamous epithelia. However, HPV in OSSN among HIV infected patients is unclear. Here, we use p16 positive immunohistochemical reactivity, a widely used biomarker to identify HPV in cervical, head and neck squamous neoplasms, on OSSN surgical excisions collected from a large HIV infected cohort from Mozambique to determine if p16 was induced in these squamous neoplasms.
OSSN surgical tissue specimens were collected from 75 Mozambican patients. Formalin-fixed, paraffin-embedded tissue blocks from these OSSNs were sectioned, stained with haematoxylin and eosin (H&E), and p16 expression by immunohistochemistry. H&E slides were reviewed to determine if OSSNs were noninvasive conjunctival intraepithelial neoplasms (CIN) or invasive squamous cell carcinomas (SCC). Cases were classified as p16 positive or negative based on diffuse nuclear and cytoplasmic expression of p16 in neoplastic cells.
p16 positivity was found in a minority of OSSN cases (14/75). p16 positivity was significantly associated with the invasive SCC type of OSSN in HIV-infected patients (p-value of 0.026).
The majority of OSSNs in our HIV infected cohort did not express p16. However, those cases that were p16-positive were significantly more likely to be the invasive SCC form of OSSN. We propose that p16 expression may identify more aggressive OSSNs in HIV-infected populations.
This is a 2020 ARVO Annual Meeting abstract.
Clinical photographs of two different patients with Ocular Surface Squamous lesions prior to surgical excision.
Ocular Surface Squamous lesions with p16 immunohistochemistry staining. A) Normal conjunctiva (H&E stain). B) CIN with abnormal cancer cells (*) within epithelium not penetrating basement membrane (black arrow) (H&E stain). C) Invasive SCC with abnormal cancer cells (*) infiltrating lamina propria (H&E stain). D) p16-negative OSSN and E) diffuse p16-positive OSSN (brown staining) compared to F) diffuse p16-positive Cervical SCC staining used as a control.
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