gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Proliferation and grading of precancerous intraepithelial neoplasias of the conjunctiva

Meeting Abstract

  • corresponding author A. Timm - Augenklinik, Universität Rostock
  • G. Stropahl - Institut für Pathologie, Universität Rostock
  • C. Sinzidi - Cliniques Universitaires de Kinshasa, Service d`Òphtalmologie
  • K. Fischer - Christoffel-Blindenmission Masvingo, Simbabwe
  • M. Schittkowski - Augenklinik, Universität Rostock
  • E. Reisinger - Klinik für Innere Medizin, Universität Rostock
  • R. F. Guthoff - Augenklinik, Universität Rostock

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.07.04

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

Published: September 22, 2004

© 2004 Timm 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.




Epithelial neoplasias of the conjunctiva are rare diseases of the higher age. A higher incidence is known from some parts of sub-Saharan Africa. Partly, in connection with the HIV epidemic in such African countries a dramatic increasing number of these tumors was observed. These neoplasias showed partially an unusually aggressive course and frequently were concerned younger patients. An aim of our investigations was the determination of the cellular proliferative activitiy as objective parameter of precancerous conjunctival lesions in correlation to their severity level and compared with non-neoplastic lesions and carcinomas.


Specimens of 98 patients from three African centers with the following histological lesions were included into the study: Pingueculae (15 cases), mild dysplasia (10), moderate dysplasia (15), severe dysplasia (13), carcinomata in situ (14) and squamous cell carcinoma (SCC, 31). Immunohistological reaction for Ki-67 was done in all samples. Positive staining was indicated as percentage and graduated. 40 of 62 tested patients were HIV positive.


96% of all pingueculae and mild dysplasias showed a Ki-67-index up to 25%. 33% of these patients were HIV positive. In contrast to it 45% of the moderate and severe dysplasias as well as carcinomata in situ similarly as the SCC (42%) showed a proliferationsrate from 26 to 83%; among them were 46% of HIV positive cases.


Moderate and severe dysplasias show a high proliferative activity similary to SCC. The Ki-67-index of mild dysplasias is significantly lower accordingly to non-neoplastic epithelial lesions. After our results appears meaningful under prognostic criteria a graduation of these precancerous lesions in low- and high-grade conjunctival intraepithelial neoplasias (ConIN). The more frequent occurrence of HIV positive cases in high-grade ConIN might be indicate a more rapid progressive course of carcinogenesis in patients with immunosuppression.