Evaluation of epithelial cell proliferating activity and fibroblast nuclear kariometry in recurrent pterygium treated with mitomycin C

To evaluate the effectiveness of mitomycin C (MMC) in preventing recurrence of pterygium following conjunctival autograft transplantation (CAT). Ki-67 antigen to evaluate epithelial cell proliferation and fibroblast nuclear kariometry were used to assist treatment evaluation. Twenty-nine patients wi...

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Published in:	Arquivos brasileiros de oftalmologia Vol. 71; no. 4; pp. 568 - 575
Main Authors:	Almeida Junior, Gildasio Castello de, Frederico, Fabio Batista, Watanabe, Karina Paula, Garcia, Tatiana Vanucci, Iquejiri, Angela Yuri, Cury, Patrícia Maluf, Taboga, Sebastião Roberto, Azoubel, Reinaldo
Format:	Journal Article
Language:	English
Published:	Brazil Conselho Brasileiro de Oftalmologia 01-07-2008
Subjects:	Adult Antimetabolites, Antineoplastic - therapeutic use Cell Proliferation - drug effects Conjunctiva - cytology Conjunctiva - transplantation Corneal Transplantation Epithelial Cells - cytology Epithelial Cells - drug effects Fibroblast Growth Factors - analysis Humans Karyometry Ki-67 Antigen - analysis Middle Aged Mitomycin - therapeutic use Ophthalmic Solutions - therapeutic use OPHTHALMOLOGY Proliferating Cell Nuclear Antigen - analysis Pterygium - drug therapy Pterygium - metabolism Pterygium - prevention & control Secondary Prevention Statistics, Nonparametric Treatment Outcome Pterygium Recurrence Mitomycin Epithelial cells Pterígio Ki-67 antigen Karyometry Fibroblastos Recidiva Cariometria Antígeno Ki-67 Mitomicina Fibroblasts Células epiteliais
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Summary:	To evaluate the effectiveness of mitomycin C (MMC) in preventing recurrence of pterygium following conjunctival autograft transplantation (CAT). Ki-67 antigen to evaluate epithelial cell proliferation and fibroblast nuclear kariometry were used to assist treatment evaluation. Twenty-nine patients with recurrent pterygium were divided into three groups: Group (G) 1--CAT and placebo eyedrops (PED); G2--CAT, 0.015% MMC subconjunctivally, and PED; G3--CAT and 0.02% MMC eyedrops. Immunohistochemistry for the Ki-67 antigen and fibroblast nuclei kariometry were performed on the excised tissue, divided into nasal and temporal sides. Kariometry was evaluated in terms of volume (Vl) and area (Ar) using at least 50 cells/patient. The percentage of positive epithelial cells for the Ki-67 antigen on the nasal and temporal side after treatment of the three groups were: nasal (5.39% G1, 4.49% G2, and 3.88% G3); temporal (3.30% G1, 4.46% G2, 4.14% G3), did not show significant differences. Fibroblast nucleus kariometry was: nasal Vl (792.1 mu3 G1, 605.1 mu3 G2, and 549.9 mu3 G3) and Ar (100.58 mu2 G1, 83.13 mu2 G2, and 78.41 mu2 G3). The three groups showed significant differences: p=0.039 and p=0.035, for respectively Vl and Ar, on the nasal side. After a six month of treatment, the three groups presented the following recurrence rates: G1, 22.22%, G2, 18.18% and G3, 33.33%, respectively. MMC did not reduce the number of positive epithelial cells for the Ki-67 antigen in recurrent pterygium, but decreased fibroblast nucleus volume and area on the nasal side of the pterygia. The number of positive epithelial cells for the Ki-67 antigen seemed not to be related to pterygium recurrence observed over a six-month post-surgery period. The role of epithelial cell proliferation in pterygium recurrence should be evaluated by further studies.
ISSN:	0004-2749 1678-2925 1678-2925
DOI:	10.1590/S0004-27492008000400019