gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Long-term persistence of therapy-induced DNA-polyploidy in conjunctival cells after topical application of Mitomycin C and radiation therapy

Meeting Abstract

  • corresponding author G. Schilgen - Department of Ophthalmology, Heinrich-Heine University, Düsseldorf
  • R. Sundmacher - Department of Ophthalmology, Heinrich-Heine University, Düsseldorf
  • N. Pomjanski - Institute of Cytopathology, Heinrich-Heine University, Düsseldorf
  • A. Böcking - Institute of Cytopathology, Heinrich-Heine University, Düsseldorf

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.11.03

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Schilgen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




The topical application of Mitomycin C (MMC) as well as radiation therapy are well established in the treatment of dysplastic or malignant cell changes of the conjunctiva. They are often used as sole or adjunctive therapy concepts. Reactive non-malignant cell changes can be seen regularly at the end of a treatment course. To differentiate these harmless alterations from malignant recurrences by common histological and cytological methods may be quite difficult in specific cases. DNA-image cytometry has offered a new perspective in the last years. It has helped to differentiate between the normal DNA-polypoidy, non-neoplastic cell changes due to the treatment and neoplastic aneuploid lesions.


Up to February 2004 we have evaluated 24 patients (24 eyes) with conjunctival intraepithelial neoplasia (CIN), 6 patients (6 eyes) with invasive squamous cell carcinoma and 8 patients (8 eyes) with malignant melanoma of the conjunctiva. Primary treatment consisted of topical MMC-Application (n=5), surgery plus postoperative MMC-Application (n=21), or surgery plus postoperative radiation therapy (n=12). Brush smears of the conjunctiva where obtained before, during and after completion of the treatment courses. At first, the obtained brush smears were evaluated by cytology. After Feulgen restaining, the DNA content of reactively changed cells was determined using the AutoCyte Quic-DNA® workstation.


During and after the treatment 100% of patients (38/38) showed a non-neoplastic, euploid DNA-polyploidy of cytomorphologically suspicious cells due to the treatment with MMC and/or radiation therapy. These changes persisted in 76,5% of the cases (26/34) after 1 year, in 50% of the cases (15/30) after 2 years and in 35,7% of the cases (10/28) even after 3 years. Tumor recurrences were detected through DNA-aneuploidy in 13 patients.


The treatment of dysplastic or malignant changes of the conjunctiva by topical application of MMC-eyedrops or by radiation therapy leads to reactive cell alterations of the epithelial cells of the conjunctiva such as euploid DNA-polyploid changes. They are observed even years after the end of a treatment. DNA-image-cytometry offers a new and promissing method to differentiate between reactive long-term-changes and real malignant recurrences.