1
|
The immunohistochemical profile of basal cell nevus syndrome-associated and sporadic odontogenic keratocysts: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:3351-3367. [PMID: 33730212 DOI: 10.1007/s00784-021-03877-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To provide a systematic review of the literature on studies comparing the immunoprofile of nevoid basal cell carcinoma syndrome (BCNS)-associated and sporadic odontogenic keratocysts (OKCs), in order to identify markers that could accurately distinguish the two OKC subtypes. MATERIALS AND METHODS We searched MEDLINE/Pubmed, Web of Science, EMBASE via OVID, and grey literature for publications until December 28th, 2019, that compared the immunohistochemical expression of the two OKC subtypes. The studies were qualitatively assessed using the Critical Appraisal Tool for Case Series (Joana Briggs Institute). Sensitivity and specificity, positive and negative likelihood ratio, diagnostic odds ratio and area under the curve, and pooled estimates were calculated, using a random-effects model. RESULTS Seventy-one studies were qualitatively analyzed; 61 markers were evaluated in one study and 32 in ≥ 2 studies. Twenty-five studies reported differential expression of 29 markers in the form of higher number of positive cells or greater staining intensity usually in BCNS-associated OKCs. Meta-analysis for bcl-2, Cyclin D1, CD56, CK18, p53, and PCNA showed that none of those markers is distinguishable between BCNS-associated and sporadic OKCs, in a 95% confidence interval. The risk of bias was high in 34 studies, moderate in 22, and low in 15. CONCLUSIONS The present systematic review and meta-analysis uncovered that, although several immunohistochemical markers might characterize the OKC phenotype, they cannot discriminate between the BCNS-associated and sporadic OKCs. CLINICAL RELEVANCE This study highlighted the requirement for additional screening for markers by immunohistochemistry, preferentially coupled to alternative diagnostic applications such as genomics technologies.
Collapse
|
2
|
Santos HBDP, Morais EFD, Cavalcante RB, Nogueira RLM, Nonaka CFW, Souza LBD, Freitas RDA. Immunoexpression of DNA base excision repair and nucleotide excision repair proteins in ameloblastomas, syndromic and non-syndromic odontogenic keratocysts and dentigerous cysts. Arch Oral Biol 2019; 110:104627. [PMID: 31862643 DOI: 10.1016/j.archoralbio.2019.104627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the immunoexpression of DNA base excision repair (BER) [apurinic/apyrimidinic endonuclease 1 (APE-1), X-ray repair cross complementing 1 (XRCC-1)] and nucleotide excision repair (NER) [xeroderma pigmentosum complementation group (XPF)] proteins in benign epithelial odontogenic lesions with different biological behaviors. DESIGN Thirty solid ameloblastomas, 30 non-syndromic odontogenic keratocysts (NSOKCs), 29 syndromic odontogenic keratocysts (SKOCs), 30 dentigerous cysts (DCs) and 20 dental follicles (DFs) were evaluated quantitatively for APE-1, XRCC-1 and XPF through immunohistochemistry. RESULTS Nuclear expression of APE-1 was significantly higher in NSOKCs, SOKCs, and ameloblastomas in comparison to DCs (p < 0.001). Nuclear expression of XRCC-1 was higher in NSOKCs and SOKCs than in DCs (p < 0.05). At the nuclear level, XPF expression was higher in NSOKCs and SOKCs than in DCs and ameloblastomas (p < 0.05). A statistically significant higher expression of APE-1 (nuclear), XRCC-1 (nuclear), and XPF (nuclear and cytoplasmic) was found in all odontogenic lesion samples as compared to DFs (p < 0.05). For all lesions, there was a positive correlation between nuclear expression of APE-1 and XRCC-1 or XPF (p < 0.05). CONCLUSIONS Our results suggest a potential involvement of APE-1, XRCC-1 and XPF proteins in the pathogenesis of benign epithelial odontogenic lesions, especially in those with more aggressive biological behavior, such as ameloblastomas, NSOKCs, and SOKCs. We also showed that the expression of APE-1 was positively correlated with the nuclear expression of XRCC-1 and XPF, which may suggest an interaction between the BER and NER pathways in all odontogenic lesions studied herein.
Collapse
|
3
|
Kaczmarzyk T, Kisielowski K, Koszowski R, Rynkiewicz M, Gawełek E, Babiuch K, Bednarczyk A, Drozdzowska B. Investigation of clinicopathological parameters and expression of COX-2, bcl-2, PCNA, and p53 in primary and recurrent sporadic odontogenic keratocysts. Clin Oral Investig 2018; 22:3097-3106. [PMID: 29508125 PMCID: PMC6224022 DOI: 10.1007/s00784-018-2400-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/22/2018] [Indexed: 11/15/2022]
Abstract
Objectives Odontogenic keratocyst (OKC) presents considerable variation in aggressiveness and propensity for recurrence, yet hitherto, no explicit clinicopathological features have been determined to clearly demonstrate the potential for relapse. This retrospective study aims to investigate the prognostic relevance of various clinicopathological features as well as immunoexpression of COX-2, bcl-2, PCNA, and p53 in sporadic OKC. Materials and methods Among 41 patients with OKC treated by enucleation, the frequency of recurrence for various clinicopathological features as well as immunoexpression for COX-2, bcl-2, PCNA, and p53 was evaluated. Results The mean follow-up was 8.49 years, and recurrences were ascertained in 29.27% of cases. We found significant differences between recurrent and non-recurrent cysts in terms of multilocularity (P = 0.029), cortical perforation (P = 0.001), and lesion size (P < 0.001). Hazard risk for the recurrence was 3.362 (95% CI 1.066–10.598) for multilocular cysts, 7.801 (95% CI 2.1–28.985) for evidence of cortical perforation, and 1.004 (1.002–1.006) for 1 mm2 of lesion size on panoramic radiographs. We also found that immunoexpression of PCNA significantly correlates with the radiographic evidence of cortical perforation (P = 0.048) and that there is significant positive correlation between expression of COX-2 and bcl-2 (P = 0.001) as well as significant negative correlation between immunoexpression of COX-2 and age (P = 0.002). None of the other analyzed factors were associated with the recurrence. Conclusions Larger size, multilocularity, and cortical perforation in sporadic OKC may be correlated with the relapse. Clinical relevance Immunohistochemical analyses of COX-2, bcl-2, PCNA, and p53 lack prognostic utility in sporadic OKC.
Collapse
Affiliation(s)
- Tomasz Kaczmarzyk
- Department of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155, Kraków, Poland. .,Chair of Periodontology and Clinical Pathology of the Oral Cavity, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155, Kraków, Poland.
| | - Konrad Kisielowski
- Department of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155, Kraków, Poland
| | - Rafał Koszowski
- Academic Center of Dentistry and Specialized Medicine, Plac Akademicki 17, 41-902, Bytom, Poland
| | - Magdalena Rynkiewicz
- Department of Pathomorphology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, ul. 3 Maja 13/15, 41-800, Zabrze, Poland
| | - Ewa Gawełek
- Department of Pathomorphology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, ul. 3 Maja 13/15, 41-800, Zabrze, Poland
| | - Karolina Babiuch
- Chair of Periodontology and Clinical Pathology of the Oral Cavity, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155, Kraków, Poland
| | - Anna Bednarczyk
- Department of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155, Kraków, Poland
| | - Bogna Drozdzowska
- Department of Pathomorphology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, ul. 3 Maja 13/15, 41-800, Zabrze, Poland
| |
Collapse
|
4
|
Mendes RB, Dias RB, Figueiredo AL, Gurgel CA, Santana Filho M, Melo LA, Trierveiler M, Cury PR, Leonardi R, Dos Santos JN. Glypican-3 distinguishes aggressive from non-aggressive odontogenic tumors: a preliminary study. J Oral Pathol Med 2016; 46:297-300. [PMID: 27647326 DOI: 10.1111/jop.12501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Glypican-3 is a cell surface proteoglycan that is found in embrionary tissues, and there are no studies investigating this protein in odontogenic tumor. Thus, the aim of this study was to investigate glypican-3 in a series of aggressive and non-aggressive odontogenic tumors. METHODS Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, 28 KOTs including five associated with Gorlin-Goltz syndrome) and non-aggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic tumors) and analyzed for glypican-3 using immunohistochemistry. RESULTS Glypican-3 was observed in seven solid ameloblastoma and eighteen keratocystic odontogenic tumors including three of the five syndromic cases, but there was no significant difference between syndromic and sporadic cases (P > 0.05; Fisher's exact Test). All cases of unicystic ameloblastoma (n = 4), adenomatoid odontogenic tumor (n = 5), and calcifying cystic odontogenic tumor (n = 2) were negative. CONCLUSIONS This provided insights into the presence of glypican-3 in odontogenic tumors. This protein distinguished aggressive from non-aggressive odontogenic tumors.
Collapse
Affiliation(s)
- Ramon Barreto Mendes
- Postgraduate Program in Human Pathology, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Rosane Borges Dias
- Postgraduate Program in Human Pathology, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Andreia Leal Figueiredo
- Department of Public Health, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Clarissa Araújo Gurgel
- Postgraduate Program in Human Pathology, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Manoel Santana Filho
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Leonardo Araújo Melo
- Laboratory of Surgical Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Marília Trierveiler
- Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Patrícia Ramos Cury
- Department of Periodontics, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rosalia Leonardi
- Department of Medical and Surgical Sciences, University of Catania, Catania, Italy
| | - Jean Nunes Dos Santos
- Postgraduate Program in Human Pathology, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.,Laboratory of Surgical Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| |
Collapse
|
5
|
Leonardi R, Perrotta RE, Loreto C, Musumeci G, Crimi S, Dos Santos JN, Rusu MC, Bufo P, Barbato E, Pannone G. Toll-like receptor 4 expression in the epithelium of inflammatory periapical lesions. An immunohistochemical study. Eur J Histochem 2015; 59:2547. [PMID: 26708181 PMCID: PMC4698613 DOI: 10.4081/ejh.2015.2547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/15/2015] [Accepted: 10/01/2015] [Indexed: 01/20/2023] Open
Abstract
Toll-like receptors (TLR) are essential for the innate immune response against invading pathogens and have been described in immunocompetent cells of areas affected by periapical disease. Besides initiating the inflammatory response, they also directly regulate epithelial cell proliferation and survival in a variety of settings. This study evaluates the in situ expression of TLR4 in periapical granulomas (PG) and radicular cysts, focusing on the epithelial compartment. Twenty-one periapical cysts (PC) and 10 PG were analyzed; 7 dentigerous non-inflamed follicular cyst (DC) served as control. TLR4 expression was assessed by immunohistochemistry. TLR4 immunoreaction products were detected in the epithelium of all specimens, with a higher percentage of immunostained cells in PG. Although TLR4 overexpression was detected in both PG and PC, there were differences that seemed to be related to the nature of the lesion, since in PG all epithelial cells of strands, islands and trabeculae were strongly immunoreactive for TLR4, whereas in PC only some areas of the basal and suprabasal epithelial layers were immunostained. This staining pattern is consistent with the action of TLR4: in PG it could promote formation of epithelial cell rests of Malassez and in epithelial strands and islands the enhancement of cell survival, proliferation and migration, whereas in PC TLR4 could protect the lining epithelium from extensive apoptosis. These findings go some way towards answering the intriguing question of why many epithelial strands or islands in PG and the lining epithelium of apical cysts regress after non-surgical endodontic therapy, and suggest that TLR4 plays a key role in the pathobiology of the inflammatory process related to periapical disease.
Collapse
|