الفهرس 
Introduction
Hypothesis and aim of the workOnly 14 pages are availabe for public view
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Abstract
Conjunctival tumors are one of the most frequent tumors of the eye among which, squamous neoplasia is considered to be the commonest. CIN is capable of progression to squamous cell carcinoma causing ocular morbidity and threaten vision.
Multiple mutagenic agents and risk factors have been involved in CIN etiology. However, up to date, the exact pathogenesis is not well understood.
Cytokeratin 17 is one of type I acidic keratin family. It acts as an oncoprotein and facilitates the progression of several tumors. However, its role in CIN pathogenesis is not fully investigated. So, we hypothesized that CK17 may play a role in CIN pathogenesis. To test this hypothesis, immunohistochemical expression of CK17 antibody was studied in correlation with the clinicopathological features in both neoplastic and non-neoplastic conjunctival specimens.
Formalin fixed paraffin embedded blocks of seventy-two excisional conjunctival specimens retrieved from the archives of the Private Surgical Pathology Laboratory of Prof. Dr. Sana Soliman A. Kroosh during the period from 2009 to 2017, were included and divided into two groups:
1- Neoplastic group: including 40 specimens of CIN and 15 specimens of conjunctival SCCdenovo.
2- Non-neoplastic group: including 10 specimens of pterygium and 7 specimens of morphologically normal conjunctiva (as a control group, obtained from excisional biopsies of other non-neoplastic lesions including: 4 conjunctival implantation cysts, 2 dermolipomas and 1 disc dermoid).
All neoplastic lesions (CIN and SCC) showed diffuse cytoplasmic staining with higher mean of intensity in SCC than CIN. On the contrary, almost all non-neoplastic lesions showed limited basal expression of CK17.
A statistical significant difference in the mean of CK17 expression was found between CIN and non-neoplastic lesions (p<0.0001) and between SCC and CIN (p<0.0001). However, no statistical significant difference could be detected between CK17 expression and all the clinicopathological features in both neoplastic and non-neoplastic specimens.
Conclusions:
• The higher expression of CK17 in CIN in comparison to the non-neoplastic lesions suggests its role as an early marker of carcinogenesis in the conjunctiva.
• The increased expression of CK17 in SCC in comparison to CIN, suggests its role in progression and invasion.
• The diffuse expression of CK17 in CIN and SCC in comparison to its limited basal expression in non-neoplastic epithelium, may suggests the role of CK17 in differentiation between benign and malignant conjunctival lesions.
Recommendations:
• Further prospective studies include large sample size with detailed clinical data including (site, size, number, duration, recurrence and follow up data of the patients) are recommended to assess the correlation between CK17 expression with patient outcome and tumor aggressiveness.
• All the CIN specimens in the current study were high grade, so further studies including lower degrees of CIN (mild and moderate) are recommended to assess the possible role of CK17 in differentiating benign and malignant conjunctival lesions.
• Further molecular analysis is still necessary to evaluate the role of CK17 in CIN pathogenesis.
• Studies to evaluate the significance of CK17 as a therapeutic target for CIN are recommended.