MICROENVIRONMENT ALTERATIONS IN CONJUNCTIVAL NEOPLASTIC LEOSIONS WITH DIFFERENT PROLIFERATION-APOPTOTIC CHARACTERISTICS.

Different studies indicate that tumor infiltrating lymphocytes (TILs) and tumor associated neutrophils (TANs) play an important role during the progression of malignant tumors. We have analysed the distribution of tumor associated neutrophils (TANs) and tumor infiltrating lymphocytes (TILs) in different conjunctival lesions, with different proliferation and apoptotic characteristics. The distribution of TILs and TANs were evaluated in standard haematoxylin and eosin (H&E) stained sections using the digital pathology software QuPathin normal conjunctiva, actinic keratosis, pterigea, conjunctival intraepithelial neoplasias (CoIN1-3) and conjunctival squamous cell carcinoma (CSCC). In addition, the expression of following markers were investigated using standard immunohistochemistry: Ki67, Bcl2, p53, CD3, CD8 and Foxp3. The study results indicated that the number of TILs and TANs are significantly increased during the progression of conjunctival intraepithelial lesions. Also, the number of TILs and TANs significantly correlate with higher proliferation index, lower apoptotic index and the p53 mutation status.