Abstract
BackgroundOcular surface squamous neoplasia (OSSN) is a rare cancer that has increased in incidence with the HIV pandemic in Africa. The underlying cause of this cancer in HIV-infected patients from Botswana is not well defined.ResultsTissues were obtained from 28 OSSN and 8 pterygia patients. The tissues analyzed from OSSN patients were 83% positive for EBV, 75% were HPV positive, 70% were KSHV positive, 75% were HSV-1/2 positive, and 61% were CMV positive by PCR. Tissues from pterygium patients were 88% positive for EBV, 75% were HPV positive, 50% were KSHV positive, and 60% were CMV positive. None of the patients were JC or BK positive. In situ hybridization and immunohistochemistry analyses further identified HPV, EBV, and KSHV in a subset of the tissue samples.ConclusionWe identified the known oncogenic viruses HPV, KSHV, and EBV in OSSN and pterygia tissues. The presence of these tumor viruses in OSSN suggests that they may contribute to the development of this malignancy in the HIV population. Further studies are necessary to characterize the molecular mechanisms associated with viral antigens and their potential role in the development of OSSN.
Highlights
Ocular surface squamous neoplasia (OSSN) is a rare cancer that has increased in incidence with the HIV pandemic in Africa
Histological analysis was obtained on the samples except for six where no histological information was provided, and indicated that some of the tumors were squamous cell carcinoma (SCC), surface squamous cell carcinoma (SSCC), pterygia, severe dysplasia, moderate, and mild dysplasia (Table 1)
H and E staining of OSSN tissues typically shows in situ carcinoma characterized by full thickness changes in nuclear to cytoplasm ratio, nuclear pleomorphism, dyskeratotic cells, and the presence of koilocytes from human papillomavirus (HPV) infection that could be seen in some lesions (Figure 2C)
Summary
Ocular surface squamous neoplasia (OSSN) is a rare cancer that has increased in incidence with the HIV pandemic in Africa. The underlying cause of this cancer in HIV-infected patients from Botswana is not well defined. OSSN has gained interest in the past few years in its association with the HIV pandemic and its increase in incidence is collinear with the increase in HIV [3]. Prior to the HIV pandemic, OSSN was noted to occur predominantly in the elderly for whom it is the third most common oculoorbital tumor after melanoma and lymphoma [4,5]. In Africa, OSSN is becoming more common, more aggressive, and more likely to affect young people, especially females [6]
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