1
|
Ngokwe ZB, Bienvenue NND, Siafa BA, Stephane NK, Sando Z. Secondary maxillary ameloblastic carcinoma: A case report. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
|
2
|
de Souza Vieira G, de Pinho Montovani P, Rozza-de-Menezes RE, Cunha KSG, Conde DC. Comparative Analysis Between Dentinogenic Ghost Cell Tumor and Ghost Cell Odontogenic Carcinoma: A Systematic Review. Head Neck Pathol 2021; 15:1265-1283. [PMID: 34128137 PMCID: PMC8633206 DOI: 10.1007/s12105-021-01347-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
Dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) form a spectrum of rare benign and malignant odontogenic neoplasms, respectively. The aim of this study was to perform a comparative systematic review of the clinicopathological, genetic, therapeutic, and prognostic features of DGCT and GCOC. The electronic search was performed until December 2020 on seven electronic databases. Case reports, series, and research studies with enough histopathological criteria for diagnosis and all genomic studies were included. Both DGCT and GCOC showed a male prevalence (p = 0.043), with mandibular and maxillary predilections, respectively (p = 0.008). Peripheral DGCT (DGCTp) affected most elderly people (p < 0.001), and central DGCT (DGCTc) and GCOC occurred mainly in younger individuals. Unilateral enlargement of maxilla or mandible was the most common clinical sign associated with a radiolucent or mixed image. Ameloblastomatous epithelium was often present in both neoplasms. Basaloid and large cells with vesicular nuclei were also frequently seen in GCOC. β-catenin expression and mutations (CTNNB1 gene) were found in DGCT and GCOC. Conservative surgery was mostly used for DGCTp, while radical resection was chosen for DGCTc and GCOC. High recurrence rates were found in DGCTc and GCOC. Metastasis occurred in 16.7% of GCOC cases and the 5-year survival rate was 72.6%. DGCT and GCOC share numerous clinicopathological features and demand a careful histopathological evaluation, considering the overlap features with other odontogenic tumors and the possibility of malignant transformation of DGCT. A strict regular post-operative follow-up is mandatory due to high recurrence rates and metastatic capacity in GCOC.
Collapse
Affiliation(s)
- Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Gonçalves Cunha
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Danielle Castex Conde
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil.
| |
Collapse
|
3
|
Sant'Ana MSP, Dos Santos Costa SF, da Silva MP, Martins-Chaves RR, Pereira TDSF, de Oliveira EM, Martínez Pedraza R, de Castro WH, Gomes CC, Gomez RS, Fonseca FP. BRAF p.V600E status in epithelial areas of ameloblastoma with different histological aspects: Implications to the clinical practice. J Oral Pathol Med 2021; 50:478-484. [PMID: 33377543 DOI: 10.1111/jop.13155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND BRAF p.V600E is reported in up to 80% of ameloblastomas. Despite the high frequency, the presence of this mutation in different histopathological areas of the tumour has not been investigated. This information has an important role in the use of BRAF p.V600E assessment as an auxiliary tool in the differential diagnosis between unicystic ameloblastoma and other odontogenic cystic lesions, especially when only incisional biopsies are available. Therefore, the purpose of the present study was to investigate BRAF p.V600E heterogeneity in unicystic ameloblastoma. METHODS Five cases of ameloblastoma and two dentigerous cysts were analysed. The regions exhibiting different microscopic characteristics were selected from each ameloblastoma case and manually dissected. TaqMan allele-specific qPCR or Sanger sequencing was performed to determine BRAF p.V600E status. RESULTS We screened the mutation in a small cohort of UA and no molecular heterogeneity was found. Four cases of ameloblastoma (80%) exhibited BRAF p.V600E in all different areas evaluated. One case did not harbour the mutation in any microscopic region analysed. The BRAF mutation was absent in the dentigerous cysts. CONCLUSION Ameloblastomas appear to exhibit a homogeneous profile regarding the BRAF p.V600E no matter what histological feature is observed under light microscopy, suggesting that this molecular test may contribute to establish the correct diagnosis in cases microscopically resembling other odontogenic lesions.
Collapse
Affiliation(s)
- Maria Sissa Pereira Sant'Ana
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sara Ferreira Dos Santos Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maísa Pereira da Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Roberta Rayra Martins-Chaves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Eduardo Morato de Oliveira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Martínez Pedraza
- Department of Advance General Dental Master, School of Dentistry, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Wagner Henriques de Castro
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
4
|
Study on clinical and biological characteristics of ameloblastic carcinoma. Orphanet J Rare Dis 2020; 15:316. [PMID: 33176823 PMCID: PMC7656674 DOI: 10.1186/s13023-020-01603-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ameloblastic carcinoma (AC) is an odontogenic malignant tumor which is closely related to benign ameloblastoma. Because of its rarity, diagnosis and treatment are difficult. In this study, we summarized and analyzed the clinical and biological characteristics of AC. RESULTS Fifteen patients with AC and a median age of 53 years were identified. Among of them, five patients who were tested carried a BRAF-V600E mutation. Two patients presented with cervical lymph nodes and lung metastases. Primary AC was more invasive, and the bone destruction ability of the primary type was more radical than that of the secondary type. CONCLUSIONS This study revealed that the BRAF-V600E mutation was related to the aggressive behavior of AC, and early radical resection is crucial. Moreover, targeted therapy may be a new direction in the future.
Collapse
|
5
|
Yoshimoto S, Tanaka F, Morita H, Hiraki A, Hashimoto S. Hypoxia-induced HIF-1α and ZEB1 are critical for the malignant transformation of ameloblastoma via TGF-β-dependent EMT. Cancer Med 2019; 8:7822-7832. [PMID: 31674718 PMCID: PMC6912026 DOI: 10.1002/cam4.2667] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/11/2019] [Accepted: 10/16/2019] [Indexed: 12/13/2022] Open
Abstract
Ameloblastic carcinoma (AC) is defined as a rare primary epithelial odontogenic malignant neoplasm and the malignant counterpart of benign epithelial odontogenic tumor of ameloblastoma (AB) by the WHO classification. AC develops pulmonary metastasis in about one third of the patients and reveals a poor prognosis. However, the mechanisms of AC oncogenesis remain unclear. In this report, we aimed to clarify the mechanisms of malignant transformation of AB or AC carcinogenesis. The relatively important genes in the malignant transformation of AB were screened by DNA microarray analysis, and the expression and localization of related proteins were examined by immunohistochemistry using samples of AB and secondary AC. Two genes of hypoxia-inducible factor 1 alpha subunit (HIF1A) and zinc finger E-box-binding homeobox 1 (ZEB1) were significantly and relatively upregulated in AC than in AB. Both genes were closely related in hypoxia and epithelial-mesenchymal transition (EMT). In addition, expressions of HIF-1α and ZEB1 proteins were significantly stronger in AC than in AB. In the cell assays using ameloblastoma cell line, AM-1, hypoxia condition upregulated the expression of transforming growth factor-β (TGF-β) and induced EMT. Furthermore, the hypoxia-induced morphological change and cell migration ability were inhibited by an antiallergic medicine tranilast. Finally, we concluded that hypoxia-induced HIF-1α and ZEB1 were critical for the malignant transformation of AB via TGF-β-dependent EMT. Then, both HIF-1α and ZEB1 could be potential biomarkers to predict the malignant transformation of AB.
Collapse
Affiliation(s)
- Shohei Yoshimoto
- Section of PathologyDivision of Biomedical SciencesDepartment of Morphological BiologyFukuoka Dental CollegeFukuokaJapan
| | - Fumie Tanaka
- Division of Oral and Medical ManagementDepartment of Oral and Maxillofacial SurgeryFukuoka Dental CollegeFukuokaJapan
| | - Hiromitsu Morita
- Department of General DentistryFukuoka Dental CollegeFukuokaJapan
| | - Akimitsu Hiraki
- Division of Oral and Medical ManagementDepartment of Oral and Maxillofacial SurgeryFukuoka Dental CollegeFukuokaJapan
| | - Shuichi Hashimoto
- Section of PathologyDivision of Biomedical SciencesDepartment of Morphological BiologyFukuoka Dental CollegeFukuokaJapan
| |
Collapse
|
6
|
Duarte‐Andrade FF, Silva AMB, Vitório JG, Canuto GAB, Costa SFS, Diniz MG, Fernandes AP, Toledo JS, André LC, Gomes CC, Gomez RS, Fonseca FP. The importance of
BRAF‐V600E
mutation to ameloblastoma metabolism. J Oral Pathol Med 2019; 48:307-314. [DOI: 10.1111/jop.12839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/05/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Filipe Fideles Duarte‐Andrade
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - André Myller Barbosa Silva
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Jéssica Gardone Vitório
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | | | - Sara Ferreira Santos Costa
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Marina Gonçalves Diniz
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Ana Paula Fernandes
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Juliano Simões Toledo
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Leiliane Coelho André
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Carolina Cavaliéri Gomes
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| |
Collapse
|
7
|
Fahradyan A, Odono L, Hammoudeh JA, Howell LK. Ameloblastic Carcinoma In Situ: Review of Literature and a Case Presentation in a Pediatric Patient. Cleft Palate Craniofac J 2018; 56:94-100. [PMID: 29715060 DOI: 10.1177/1055665618774021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Ameloblastic carcinomas are rare malignant lesions with 3 mandibular pediatric cases reported in the literature. We present a case of ameloblastic carcinoma in situ in a 15-year-old male with a right mandibular cystic lesion on computed tomography. The incisional biopsy revealed plexiform ameloblastoma. Due to the infiltrating and aggressive nature of the tumor, the patient underwent hemimandibulectomy and immediate reconstruction with a vascularized osteocutaneous fibula free flap. The final pathology was read as ameloblastic carcinoma in situ. Given the rarity of this disease in the pediatric population, this case report may be a valuable addition to the current literature.
Collapse
Affiliation(s)
- Artur Fahradyan
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Lauren Odono
- 2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA
| | - Jeffrey A Hammoudeh
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,2 Division of Oral and Maxillofacial Surgery, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lori Kathryn Howell
- 1 Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.,3 Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| |
Collapse
|
8
|
COX-2 as a determinant of lower disease-free survival for patients affected by ameloblastoma. Pathol Res Pract 2018; 214:907-913. [PMID: 29559247 DOI: 10.1016/j.prp.2018.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/27/2018] [Accepted: 03/13/2018] [Indexed: 11/20/2022]
Abstract
Ameloblastoma is a locally aggressive neoplasm with a poorly understood pathogenesis. Therefore, the aim of this study is to investigate whether COX-2 expression is associated with ameloblastoma microvascular density (MVD) and with tumor aggressiveness. Sixty-three cases of primary ameloblastomas arranged in tissue microarray were submitted to immunohistochemistry against cyclooxigenase-2 (COX-2) and CD34. Clinicopathological parameters regarding sex, age, tumour size, tumour duration, tumour location, treatment, recurrences, radiographic features, vestibular/lingual and basal cortical disruption and follow-up data were obtained from patients' medical records and correlated with the proteins expression. The results on BRAF-V600E expression were obtained from our previous study and correlated with COX-2 and CD34 expressions. Log-rank univariate analysis and multivariate Cox regression model were done to investigate the prognostic potential of the molecular markers. Twenty-eight cases (44.4%) exhibited cytoplasmic positivity for COX-2, predominantly in the columnar peripheral cells, with a mean MVD of 2.2 vessels/mm2. COX-2 was significantly associated with recurrences (p < 0.001) and BRAF-V600E expression (p < 0.001), whereas lower MVD was associated with the use of conservative therapy (p = 0.004). Using univariate and multivariate analyses, COX-2 was significantly associated with a lower 5-year disease-free survival (DFS) rate (p < 0.001 and p = 0.012, respectively), but not with a higher MVD (p = 0.68). In conclusion, COX-2 expression in ameloblastomas is not associated with MVD, but it is significantly associated with recurrences and with a lower DFS.
Collapse
|
9
|
Fonseca FP, Monteiro Benites B, Soares CD, de Lima Morais TM, do Amaral-Silva GK, de Almeida OP, Soares FA, Fregnani ER. Prognostic importance of FGF2 and FGFR1 expression for patients affected by ameloblastoma. J Oral Pathol Med 2018; 47:417-424. [PMID: 29453876 DOI: 10.1111/jop.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fibroblast growth factor 2 (FGF2) and FGF receptor 1 (FGFR1) have been investigated in different human neoplasms and were shown to play important roles in the pathogenesis of these diseases; however, very few are known regarding their prognostic importance in the context of ameloblastoma. Therefore, the aim of this study was to investigate whether the expression of FGF2 and FGFR1 is associated with ameloblastoma clinical behavior. METHODS Fifty-eight cases of ameloblastoma arranged in tissue microarray were submitted to immunohistochemistry against FGF2 and FGFR1. Clinicopathological parameters regarding sex, age, tumor size, duration and location, treatment, recurrences, radiographic features, cortical disruptions, and follow-up data were obtained from patients' medical records and correlated with the molecules expression. Univariate and multivariate Cox regression analyses were used to investigate the prognostic potential of the biomarkers. RESULTS Forty-four cases (75.9%) exhibited cytoplasmic positivity for FGF2 in central and peripheral epithelial cells, 46 of 58 (79.3%) showed FGFR1 cytoplasmic positivity predominantly in the columnar peripheral cells, and 43 cases (74.1%) were positive for both. Expression of FGF2 and FGF2 + FGFR1 was associated with tumor recurrences (P = .05). However, univariate and multivariate analyses did not demonstrate a significant influence of FGF2, FGFR1, or FGF2 + FGFR1 in the 5-year disease-free survival (DFS) rate (P = .27, P = .33, and P = .25, respectively). CONCLUSION Cytoplasmic expression of FGF2 and FGF2 + FGFR1 is associated with ameloblastoma recurrence, but FGF2 and FGFR1 are not determinants of a lower DFS.
Collapse
Affiliation(s)
- Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ciro Dantas Soares
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas Piracicaba, Piracicaba, Brazil
| | - Thayná Melo de Lima Morais
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas Piracicaba, Piracicaba, Brazil
| | | | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas Piracicaba, Piracicaba, Brazil
| | | | | |
Collapse
|
10
|
Reconnoitre ameloblastic carcinoma: A prognostic update. Oral Oncol 2018; 77:118-124. [PMID: 29362117 DOI: 10.1016/j.oraloncology.2017.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/28/2017] [Accepted: 12/23/2017] [Indexed: 12/13/2022]
Abstract
AIM Malignant odontogenic tumor, ameloblastic carcinoma (AC) is challenging to study owing to its rarity, complexity and limited availability of literature. This further makes it difficult to establish its clinical characteristics and prognosis. Our study aimed to evaluate AC's clinico-demographic factors and their relation with prognosis and survival. MATERIALS AND METHODS Literature was systematically reviewed for cases pertaining to AC, starting from January 2000 to December 2016. All the required data was obtained, arranged and analysed using Cox regression ratio and Kaplan Meir survival analysis. From the database, 153 cases were retrieved as per the inclusion/exclusion criteria. RESULTS The results demonstrated that age of patient, mode of treatment and metastasis affects overall survival. The categorisation of AC as primary or secondary type does not have any role in determining prognosis. CONCLUSION Overall survival of AC patient depends upon age, site, treatment and metastasis. For a better prognosis early surgical management of the tumor appears to be the most favourable mode of treatment.
Collapse
|
11
|
Amaral-Silva GKD, Sánchez-Romero C, Wagner VP, Martins MD, Pontes HAR, Fregnani ER, Soares FA, Almeida OPD, Rocha AC, Santos-Silva AR, Fonseca FP, Vargas PA. Prognostic significance of hMSH2, hMSH3, and hMSH6 expression in ameloblastoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:286-295. [DOI: 10.1016/j.oooo.2017.05.511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/23/2017] [Accepted: 05/30/2017] [Indexed: 01/18/2023]
|
12
|
Fregnani ER, Perez DEDC, Paes de Almeida O, Fonseca FP, Soares FA, Castro-Junior G, Alves FA. BRAF-V600E expression correlates with ameloblastoma aggressiveness. Histopathology 2016; 70:473-484. [PMID: 27681305 DOI: 10.1111/his.13095] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/23/2016] [Indexed: 12/18/2022]
Abstract
AIMS The aim of this study was to investigate whether the expression of BRAF-V600E determines an aggressive clinical and molecular presentation of ameloblastoma. METHODS AND RESULTS Ninety-three cases of solid ameloblastomas were arranged in a 1.0-mm tissue microarray (TMA) block. Immunohistochemistry against a large panel of cytokeratins (CK), epidermal growth factor receptor (EGFR), parathyroid hormone-related peptide (PTHrP), syndecan-1, Ki67, p53 and BRAF-V600E were performed. Clinicopathological parameters, including sex, age, tumour size, tumour duration, tumour location, treatment, recurrences, radiographic pattern, vestibular/lingual and basal cortical plates disruption and follow-up data, were obtained from patients' medical records. Immunoexpression of BRAF-V600E was investigated in 73 cases that remained available in TMA sections. Our results indicated that 46.6% (34 cases) demonstrated cytoplasm positivity (six weak and 28 strong positivity). BRAF-V600E expression was associated significantly with the expression of CK8 (P = 0.00077), CK16 (P = 0.05), PTHrP (P = 0.0082) and p53 (P = 0.0087). Additionally, a significant association was seen with the presence of recurrences (P = 0.0008), multilocular radiographic appearance (P = 0.044) and disruption of basal bone cortical (P = 0.05). Univariate analysis showed that BRAF-positive cases (P = 0.001), EGFR-negative/weak positive cases (P = 0.03) and multilocular tumours (P = 0.04) had a significantly lower disease-free survival rate, but these parameters were not considered independent prognostic factors in the multivariate analysis (P > 0.05). CONCLUSIONS Our findings suggest an association of BRAF-V600E with parameters of a more aggressive behaviour of ameloblastoma, supporting the future use of BRAF inhibitors for targeted therapy of this neoplasm.
Collapse
Affiliation(s)
| | | | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernando A Soares
- Department of Pathology, A C Camargo Cancer Center, São Paulo, Brazil
| | - Gilberto Castro-Junior
- Clinical Oncology, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fábio A Alves
- Department of Oral Medicine, A C Camargo Cancer Center, São Paulo, Brazil
| |
Collapse
|