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Bovi C, Luchena A, Bivona R, Borsetto D, Creber N, Danesi G. Recurrence in cholesteatoma surgery: what have we learnt and where are we going? A narrative review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:S48-S55. [PMID: 37698100 PMCID: PMC10159641 DOI: 10.14639/0392-100x-suppl.1-43-2023-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 09/13/2023]
Abstract
Treatment of cholesteatoma is surgical and has historically encompassed two main techniques: canal wall up (CWU) and canal wall down (CWD) tympanoplasty. Follow-up for cholesteatoma is still debated and can be either radiological or with second-look surgery. MRI with diffusion weighted sequences has proved to have high sensitivity and specificity in detecting recurrent or residual disease. Specifically, non-echo planar imaging DWI (non-EPI DWI) has been shown to be superior to other imaging techniques, allowing, in some cases, to avoid second-look surgery. Both residual and recurrence rates are higher in CWU compared to CWD procedures. Endoscopic ear surgery (EES) has become popular with the advantage of “looking around corners”. The endoscope is used in addition to a microscope or exclusively to reduce cholesteatoma recurrence. In addition, it has been demonstrated that mastoid obliteration and the use of potassium titanyl phosphate laser (KTP) can reduce cholesteatoma recurrence, with better functional outcomes. A synthetic sulphur compound (MESNA) may have an interesting role in the overall improvement in recurrence and residual cholesteatoma disease. This narrative review critically appraises the factors associated with the risk of recurrent cholesteatoma.
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Affiliation(s)
- Chiara Bovi
- Otolaryngology Department, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alberto Luchena
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico “San Matteo”, Pavia, Italy
| | - Rachele Bivona
- Department of Neurosciences, Section of Otorhinolaryngology and Skull Base Microsurgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Daniele Borsetto
- Department of ENT Surgery, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nathan Creber
- Otolaryngology, Department of Surgery, The Royal Prince Alfred Hospital, Sydney, Australia
| | - Giovanni Danesi
- Department of Neurosciences, Section of Otorhinolaryngology and Skull Base Microsurgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
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A Role for Mast Cell-Mediated Antibodies in the Formation of Cholesteatoma and Cholesteatoma-Induced Bone Erosion. Diagnostics (Basel) 2023; 13:diagnostics13030455. [PMID: 36766559 PMCID: PMC9914080 DOI: 10.3390/diagnostics13030455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
The study aimed to evaluate the effects and relationships between mast cells in the matrix, mast cell enzymes tryptase and chymase, epithelial proliferation, microvascular density, and bone destruction in cholesteatoma. Thirty-five biopsies diagnosed with cholesteatoma and seven healthy skin tissues taken from the retro-auricular region for control were evaluated. Immunohistochemical studies were performed with CD117, CD34, Ki-67, chymase, and tryptase antibodies, in a single session for all cases and the control group. The relationship between erosion size and antibody load was determined. The mean cholesteatoma epithelium Ki-67 was higher than the control group (p < 0.001). CD117-positive mast cells, chymase-positive mast cells, tryptase-positive mast cells, and microvessel density were significantly higher in the cholesteatoma matrix compared to the control group (p < 0.002, p < 0.001, p < 0.005). In the group with bone erosion scores of two and above, immunohistochemical markers tended to be higher. A positive correlation was found between CD117 and chymase, tryptase, and microvessel density; between tryptase, chymase, and microvessel density; and between chymase and microvessel density. CD117-positive mast cells and chymase-positive mast cells stimulate angiogenesis, increase the epithelium's proliferative capacity in the cholesteatoma matrix, and form cholesteatoma. The increased proliferation of cholesteatoma epithelium and increased vascular density in the matrix exacerbate bone erosion.
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Araz Server E, Kalaycık Ertugay Ç, Baykal Koca S, Longur ES, Yiğit Ö, Demirhan H, Çakır Y. Predictive Role of Ki-67 and Proliferative-Cell Nuclear Antigen (PCNA) in Recurrent Cholesteatoma. J Int Adv Otol 2020; 15:38-42. [PMID: 30541725 DOI: 10.5152/iao.2018.4976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To investigate the potential use of Ki-67 and pronuclear cell antigen (PCNA) as indicators of recurrent cholesteatoma. MATERIAL AND METHODS Patients who had been diagnosed with cholesteatoma and who had undergone canal wall-down mastoidectomy were included in this study. Subjects were divided into two groups: recurrent and non-recurrent (i.e., cases without recurrence for at least 2 years). Ossicular pathologies were recorded. Histopathologic specimens were stained for Ki-67 and PCNA and the percentages of stained cells were calculated. RESULTS Neither group demonstrated a significant difference in terms of total Ki-67 per cell, Ki-67-stained cell counts, Ki-67-staining percentages, total PCNA per cell, PCNA-stained cell counts, or PCNA-staining percentages (p>0.05). No significant relationship was noted between the staining percentages for either Ki-67 or PCNA and the incudostapedial involvement (p>0.05); however, a significant relationship was noted between Ki-67 staining and malleus involvement (p<0.05). CONCLUSION Although the recurrent and non-recurrent cholesteatoma groups showed no significant differences in terms of the percentages of stained cells for either Ki-67 or PCNA, we detected high Ki-67 staining in the malleus involvement group. We concluded that cell-proliferation markers could not be defined as indicators of recurrence of cholesteatoma, but they could be defined as indicators of destructive patterns of this disease.
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Affiliation(s)
- Ela Araz Server
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Çiğdem Kalaycık Ertugay
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Sevim Baykal Koca
- Department of Pathology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Ecem Sevim Longur
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Özgür Yiğit
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Hasan Demirhan
- Department of Otorhinolaryngology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Yasemin Çakır
- Department of Pathology, İstanbul Training and Research Hospital, İstanbul, Turkey
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Zhang F, Guo F. Effect of transplantation of cardiac stem cells overexpressing integrin-linked kinase on cardiac function of rats with acute myocardial infarction. Exp Ther Med 2018; 16:746-750. [PMID: 30116329 PMCID: PMC6090253 DOI: 10.3892/etm.2018.6198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/30/2018] [Indexed: 12/15/2022] Open
Abstract
In the present study, we aimed to investigate the effect of transplantation of cardiac stem cells (CSCs) overexpressing integrin-linked kinase (ILK) on cardiac function of rats with acute myocardial infarction (MI). A total of 60 rats were randomly divided into normal saline (NS) group (n=20), green fluorescent protein (GFP)-CSC group (n=20) and ILK-CSC group (n=20). In the ILK-CSC group, CSCs in rats were transfected with GFP adenovirus vector overexpressing ILK. The rat model of MI was established. The cardiac function 4 weeks after transplantation was detected via echocardiography, and the exhaustive swimming experiment was performed to observe the exercise load capacity. Moreover, Ki-67 and P-H3 proteins in myocardial tissues of rats were detected via immunohistochemistry, and the expression of GFP was observed under a fluorescence microscope. Cells in the GFP-CSC group were transfected with the empty GFP adenovirus, while those in NS group were not transfected, and other treatments in these two groups were the same as those in the ILK-CSC group. Four weeks after transplantation, left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) of rats in the ILK-CSC group were smaller than those in the GFP-CSC group, but left ventricular ejection fraction (LVEF) (69.88±5.61 mm) was higher than that in the GFP-CSC group (P<0.05). The exercise time in the ILK-CSC group (12.69±0.58 min) was longer than that in the GFP-CSC and NS groups (P<0.05). The expression levels of Ki-67 and P-H3 proteins in myocardial cells of rats in the ILK-CSC group were higher than those in the GFP-CSC and NS groups (P<0.05). The number of transplanted cells retained around the infarct region in the ILK-CSC group 3 days after transplantation was obviously larger than that in the GFP-CSC group (P<0.001). Intramyocardial injection of CSCs overexpressing ILK immediately after the establishment of rat model of MI can promote myocardial cell proliferation, improve cardiac function and increase exercise capacity of rats.
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Affiliation(s)
- Fengli Zhang
- Department of Cardiology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Fengyan Guo
- Department of Cardiology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
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Zhao L, Li YY, Li CW, Chao SS, Liu J, Nam HN, Dung NTN, Shi L, Wang DY. Increase of poorly proliferated p63 + /Ki67 + basal cells forming multiple layers in the aberrant remodeled epithelium in nasal polyps. Allergy 2017; 72:975-984. [PMID: 27807867 DOI: 10.1111/all.13074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Aberrant epithelial remodeling with the ectopic expression of p63 (basal cell markers) is an important pathologic phenomenon seen in chronically inflamed airway epithelium such as in nasal polyps (NPs). METHODS Biopsies were obtained from 55 NP patients and 18 healthy controls (inferior turbinate). Among NP patients, 15 were treated with oral and nasal steroids, so that two sets of NP biopsies were taken before and after the treatments. p63, Ki67, type IV β-tubulin, and cell cycle markers were investigated in these specimens. RESULTS The number of p63+ cells is significantly higher in both hyperplastic (1.53-fold, P < 0.0001) and squamous metaplastic (2.02-fold, P < 0.0001) epithelium from NPs than from healthy controls. There are three types of proliferative basal cells (p63+ /Ki67+ ) which are in different phases of the cell cycle, such as G1 phase (type I cells), S to G2 phase (type II cells), and mitosis (type III cells). Of importance, some type I cells may arrest after proliferation although they may still be p63+ /Ki67+ . In healthy epithelium, the ratio of the type I and II cells is almost 50:50. However, less type II cells are found in hyperplastic epithelium (34.85%, P = 0.012) and in squamous metaplastic epithelium (30.77%, P = 0.02) together with the presence of type III cells (3.45%, P = 0.01). These findings were not changed after steroid treatments. CONCLUSIONS An increase of poorly proliferated basal cells forming multiple layers, which may stain for basal cell markers but does not form a proper epidermal barrier, is an important histopathologic phenomenon in aberrant remodeled epithelium of NPs.
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Affiliation(s)
- L. Zhao
- Department of Otolaryngology; The Second Hospital of Shandong University; Shandong University; Jinan China
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Y. Y. Li
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - C. W. Li
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - S. S. Chao
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - J. Liu
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - H. N. Nam
- Department of Otolaryngology; Pham Ngoc Thach University of Medicine; Ho Chi Minh City Vietnam
| | - N. T. N. Dung
- Department of Otolaryngology; Pham Ngoc Thach University of Medicine; Ho Chi Minh City Vietnam
| | - L. Shi
- Department of Otolaryngology; The Second Hospital of Shandong University; Shandong University; Jinan China
| | - D. Y. Wang
- Department of Otolaryngology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Hamed MA, Nakata S, Shiogama K, Suzuki K, Sayed RH, Nishimura Y, Iwata N, Sakurai K, Badawy BS, Inada KI, Tsuge H, Tsutsumi Y. Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity. Clin Exp Otorhinolaryngol 2017; 10:213-220. [PMID: 28073243 PMCID: PMC5545701 DOI: 10.21053/ceo.2016.01263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/10/2016] [Accepted: 12/14/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Cholesteatoma is a nonneoplastic destructive lesion of the temporal bone with debated pathogenesis and bone resorptive mechanism. Both molecular and cellular events chiefly master its activity. Continued research is necessary to clarify factors related to its aggressiveness. We aimed to investigate the expression of Ki-67, cytokeratin 13 (CK13) and cytokeratin 17 (CK17) in acquired nonrecurrent human cholesteatoma and correlate them with its bone destructive capacity. METHODS A prospective quantitative immunohistochemical study was carried out using fresh acquired cholesteatoma tissues (n=19), collected during cholesteatoma surgery. Deep meatal skin tissues from the same patients were used as control (n=8). Cholesteatoma patients were divided into 2 groups and compared (invasive and noninvasive) according to a grading score for bone resorption based upon clinical, radiologic and intraoperative findings. To our knowledge, the role of CK17 in cholesteatoma aggressiveness was first investigated in this paper. RESULTS Both Ki-67 and CK17 were significantly overexpressed in cholesteatoma than control tissues (P<0.001 for both Ki-67 and CK17). In addition, Ki-67 and CK17 were significantly higher in the invasive group than noninvasive group of cholesteatoma (P=0.029, P=0.033, respectively). Furthermore, Ki-67 and CK17 showed a moderate positive correlation with bone erosion scores (r=0.547, P=0.015 and r=0.588, P=0.008, respectively). In terms of CK13, no significant difference was found between cholesteatoma and skin (P=0.766). CONCLUSION Both Ki-67 and CK17 were overexpressed in cholesteatoma tissue and positively correlated with bone resorption activity. The concept that Ki-67 can be a predictor for aggressiveness of cholesteatoma was supported. In addition, this is the first study demonstrating CK17 as a favoring marker in the aggressiveness of acquired cholesteatoma.
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Affiliation(s)
- Mahmood A Hamed
- Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.,Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Seiichi Nakata
- Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Kazuya Shiogama
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenji Suzuki
- Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.,Department of Otorhinolaryngology, Yonaha General Hospital, Kuwana, Japan
| | - Ramadan H Sayed
- Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Yoichi Nishimura
- Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Noboru Iwata
- Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Kouhei Sakurai
- Department of Pathology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Badawy S Badawy
- Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ken-Ichi Inada
- Department of Pathology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Hayato Tsuge
- Department of Otorhinolaryngology, Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Yutaka Tsutsumi
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan
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Chung JH, Lee SH, Park CW, Kim KR, Tae K, Kang SH, Oh YH, Pyo JY. Expression of Apoptotic vs Antiapoptotic Proteins in Middle Ear Cholesteatoma. Otolaryngol Head Neck Surg 2015; 153:1024-30. [DOI: 10.1177/0194599815591810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/27/2015] [Indexed: 11/16/2022]
Abstract
Objectives To explore the role of antiapoptotic and apoptotic processes in the development of cholesteatoma by investigating the expression of an antiapoptotic (c-FLIP) and apoptotic (p53) protein relative to the expression of a proliferation marker (Ki-67). Study Design Basic science study. Setting Tertiary referral center. Subjects and Methods An immunohistochemical investigation was performed on 35 cholesteatoma specimens (21 acquired, 14 congenital) and 10 normal retroauricular skins to evaluate the expression of c-FLIP, p53, and Ki-67. The expression rate of each marker was measured to assess the difference between retroauricular skin and cholesteatoma, as well as between congenital and acquired cholesteatoma. Results c-FLIP expression was significantly higher in the cholesteatoma specimens than in retroauricular skin ( P < .05), while the expression of p53 did not significantly differ between the two. Ki-67 expression in cholesteatoma was significantly higher than in retroauricular skin ( P < .001). The c-FLIP expression rate was positively correlated with that of Ki-67 ( r = 0.47, P = .001), and there was no significant correlation between the expression level of p53 and that of Ki-67 ( r = 0.152, P = .319). In addition, no differences in c-FLIP, p53, and Ki-67 expression rates were evident between congenital and acquired cholesteatoma. Conclusions The upregulation of c-FLIP together with unchanged p53 suggests an altered equilibrium between apoptosis and antiapoptosis, favoring antiapoptosis, and may play a role in the pathogenesis of cholesteatoma.
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Affiliation(s)
- Jae Ho Chung
- Departments of Otolaryngology–Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Seung Hwan Lee
- Departments of Otolaryngology–Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Chul Won Park
- Departments of Otolaryngology–Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Kyung Rae Kim
- Departments of Otolaryngology–Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Kyung Tae
- Departments of Otolaryngology–Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Sung-Ho Kang
- Department of Otorhinolaryngology, Konkuk University School of Medicine, Chungju, Korea
| | - Young Ha Oh
- Departments of Pathology, School of Medicine, Hanyang University, Seoul, Korea
| | - Ju Yeon Pyo
- Departments of Pathology, School of Medicine, Hanyang University, Seoul, Korea
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Kim KH, Lim HJ, Kim YJ, Kim SW, Kim YS, Tian C, Park K, Park TJ, Choung YH. The oncoprotein, gankyrin, is up-regulated in middle ear cholesteatoma. Acta Otolaryngol 2014; 134:238-43. [PMID: 24460153 DOI: 10.3109/00016489.2013.844362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Gankyrin seems to be a better biomarker for cholesteatoma compared with Ki-67. OBJECTIVE Gankyrin is an oncoprotein, and occurs in cancers but not in benign diseases. The goal of this study was to compare expression of gankyrin, p53, and a proliferation marker (Ki-67) in cholesteatoma and retroauricular skin (RAS), and to evaluate their significance as clinical parameters. METHODS The levels of expression of gankyrin, Ki-67, and p53 in 10 cholesteatoma and 10 paired samples of normal RAS were evaluated by immunohistochemical staining and Western blot. The results were compared with clinical profiles to investigate a correlation. RESULTS The expression of gankyrin, Ki-67, and p53 proteins was observed in both basal and suprabasal layers of cholesteatoma. The intensity of gankyrin expression was 'positive' in two cases (20%) and 'strongly positive' in eight cases (80%); p53 expression in the suprabasal layer was 'positive' in 70% of cases; and the Ki-67 staining was 'focal' in 80% of cases. In RAS, these proteins were expressed dominantly in the basal layer. Western blot analysis showed that the gankyrin band was more intense in cholesteatoma than in RAS for three of four cases (p < 0.05). However, there was no significant difference in the expression of gankyrin, Ki-67, and p53 according to clinical variables.
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Role of Langerhans cells, Ki-67 protein and apoptosis in acquired cholesteatoma: prospective clinical study. The Journal of Laryngology & Otology 2013; 127:252-9. [PMID: 23331470 DOI: 10.1017/s0022215112003180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the role of Langerhans cells in the pathogenesis and clinical picture of middle-ear cholesteatoma. SUBJECTS AND METHODS The study included 40 patients operated upon for a diagnosis of chronic otitis due to acquired cholesteatoma. RESULTS AND ANALYSIS A closed surgical technique was used in 20 per cent of patients and an open technique in 80 per cent. Langerhans cells were more densely accumulated in cholesteatoma epithelium, compared with external ear canal skin (p < 0.001). Staining for Ki-67 protein was greater in cholesteatoma epithelium (p < 0.001) and Apo2.7 protein staining (indicating apoptosis) was more prominent (p < 0.001), compared with ear canal skin. Regarding significant relationships between clinical and pathological findings, staining for Ki-67 (p = 0.046) and Apo2.7 (p = 0.037) was more prominent in patients undergoing open versus closed surgery. CONCLUSION Using cell proliferation and apoptosis markers, a dense Langerhans cell infiltration was found to occur as a host response to middle-ear cholesteatoma.
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Woo HJ, Park JC, Bae CH, Song SY, Lee HM, Kim YD. Up-regulation of neutrophil gelatinase-associated lipocalin in cholesteatoma. Acta Otolaryngol 2009; 129:624-9. [PMID: 18720059 DOI: 10.1080/00016480802342457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION Neutrophil gelatinase-associated lipocalin (NGAL) and Ki-67 expression were up-regulated in cholesteatoma and the expression pattern of NGAL in the epithelial layer was inversely related to the expression of Ki-67. Therefore, NGAL may be related to dysregulated differentiation in the keratinocytes during the development of a cholesteatoma. OBJECTIVES We investigated the differential expression and localization of NGAL in middle ear cholesteatoma and compared the results to normal external auditory canal (EAC) skin. We also compared the expression and localization of NGAL with the expression and localization of Ki-67 in middle ear cholesteatoma. SUBJECTS AND METHODS Tissue samples from middle ear cholesteatomas and normal EAC skin were obtained from 20 patients undergoing middle ear surgery. NGAL mRNA expression was determined by the reverse transcriptase-polymerase chain reaction (RT-PCR). The expression of NGAL protein was analyzed by Western blot. NGAL and Ki-67 were localized by immunohistochemical staining. RESULTS A significantly greater expression of the NGAL mRNA was observed in cholesteatoma epithelium than in normal EAC skin (p < 0.05). NGAL was detected in the granular layer of cholesteatoma. However, NGAL was scarcely expressed in normal EAC skin. Ki-67 was detected predominantly in the basal and parabasal layers of cholesteatoma epithelium.
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