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Patel P, Effiom OA, Akinshipo AWO, Akintoye SO. Differential Profile of Primary and Recurrent Ameloblastomas Among Afro-descendants and Non-Afro-descendants-a Systematic Review. J Racial Ethn Health Disparities 2024; 11:92-100. [PMID: 36596981 PMCID: PMC10437082 DOI: 10.1007/s40615-022-01500-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and inconclusive. The role of race and ethnicity on ameloblastoma growth characteristics, genetic mutational profile, and recurrence is also still unclear. The primary aim of this systematic review was to assess genetic, racial, and ethnic distribution of primary and recurrent ameloblastoma from published literature. The secondary aim was to assess potential correlations between ethnicity, genetic mutation, and disparities in ameloblastoma treatment outcomes in Afro-descendants and non-Afro-descendants. Twenty-three eligible articles were selected based on preferred reporting items for systematic review and meta-analysis (PRISMA), and a total of 169 ameloblastoma cases were evaluated. Data on patient demographics, ameloblastoma growth characteristics, and genetic status were collected for quantitative analysis. Among a total of 169 ameloblastoma cases, Afro-descendant patients had higher primary and recurrent ameloblastomas at 15.5% and 4.7% respectively compared to non-Afro-descendant at 10.7% and 1.8% respectively. Additionally, BRAF V600E was positively associated with 48.8% of all ameloblastomas and strong predilection for Afro-descendants. Despite the paucity of information on genetic profile of ameloblastomas in the Afro-descendant patient cohort, this ethnic group still accounted for 2.95% of all BRAF V600E-positive tumors. These suggest that Afro-descendants are understudied regarding ameloblastoma characteristics, genetic profile, and recurrence profile. Mutational analysis of ameloblastoma tumors in Afro-descendants should be promoted.
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Affiliation(s)
- Parth Patel
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Olajumoke A Effiom
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Abdul-Warith O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Sunday O Akintoye
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria.
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA, USA.
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Xie J, Zhang J, Xiong G, Ouyang S, Yun B, Xu X, Wang W, Zhang M, Xie N, Chen D, Wang C. Targeting BRD4 attenuates the stemness and aggressiveness of ameloblastoma. Oral Dis 2023. [PMID: 37798926 DOI: 10.1111/odi.14762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/19/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND BRD4, belonging to the bromodomain extra-terminal (BET) protein family, plays a unique role in tumor progression. However, the potential impact of BRD4 in ameloblastoma (AM) remains largely unknown. Herein, we aimed to assess the expression and functional role of BRD4 in AM. METHODS The expression level of BRD4 was assessed by immunohistochemistry. The proliferation, migration, invasion, and tumorigenic abilities of AM cells were assessed by a series of assays. To explore the molecular expression profile of BRD4-depleted AM cells, RNA sequencing (RNA-seq) was performed. Bioinformatic analysis was performed on AM expression matrices obtained from the Gene Expression Omnibus (GEO). The therapeutic efficacy of BET-inhibitors (BETi) was assessed with AM patient-derived organoids. RESULTS Upregulation of BRD4 was observed in conventional AMs, recurrent AMs, and ameloblastic carcinomas. Depletion of BRD4 inhibited proliferation, invasion, migration, and tumorigenesis in AM. Administration of BETi attenuated the aggressiveness of AM and the growth of AM patient-derived organoids. Bioinformatic analysis indicated that BRD4 may promote AM progression by regulating the Wnt pathway and stemness-associated pathways. CONCLUSION BRD4 increases the aggressiveness and promotes the recurrence of ameloblastoma by regulating the Wnt pathway and stemness-associated pathways. These findings highlight BRD4 as a promising therapeutic target in AM management.
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Affiliation(s)
- Jiaxiang Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jingqi Zhang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Gan Xiong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Shengqi Ouyang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Bokai Yun
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiuyun Xu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Wenjin Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Ming Zhang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Nan Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Demeng Chen
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Cheng Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
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A Rare Case of a Large Ameloblastoma and Cervical Lynphoepitelial Cyst Treated Simultaneously by an Intraoral Approach and Immediate Reconstruction. J Craniofac Surg 2022; 34:e208-e212. [PMID: 35994740 DOI: 10.1097/scs.0000000000008928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022] Open
Abstract
Ameloblastoma is a benign locally aggressive odontogenic tumor of epithelial origin with unlimited growth capacity. Cervical lymphoepithelial cyst is a developmental cyst located in the superior-lateral region of the neck with treatment consisting of surgical excision, which presents low recurrence rates. This article reports the case of patient J.G.S.L., 24 years old, female, who reported to the service with a histopathological evaluation compatible with intraosseous mandibular ameloblastoma. On physical examination, a nontender swelling was palpable along the body of left mandible where the ameloblastoma was located, with a fluctuant region detected just below it. Imaging exams confirmed the suspicion of two independent lesions. The treatment plan consisted of two stages: first, mandibular resection of the area affected by the ameloblastoma, followed by reconstruction with a titanium plate simultaneous to excisional biopsy of the as yet undiagnosed lesion, both through intraoral access; second, mandibular reconstruction with iliac crest graft. Histopathological examination of the second lesion indicated a diagnosis of cervical lymphoepithelial cyst, being the first case in the literature with these concomitant lesions. Currently, the patient is in her third postoperative year with no signs of recurrence.
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Lawson‐Michod KA, Le CH, Tranesh G, Thomas PC, Bauman JE. Precision medicine: Sustained response to erdafitinib in
FGFR2
‐mutant, multiply recurrent ameloblastoma. Cancer Rep (Hoboken) 2022; 5:e1656. [PMID: 35761436 PMCID: PMC9575481 DOI: 10.1002/cnr2.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/26/2022] [Accepted: 05/19/2022] [Indexed: 11/20/2022] Open
Abstract
Background Ameloblastoma imposes significant morbidity and high‐recurrence rates following surgery and radiation therapy. Although 89% of cases harbor oncogenic mutations, the role of targeted therapy is undefined. Case We describe a case of a 40‐year‐old male with multiply recurrent, locally invasive ameloblastoma of the posterior maxillary ridge. The tumor was unresectable for negative margins due to extensive intracranial disease, and the patient suffered severe symptoms including pain. Immune and genomic profiling were obtained to guide systemic treatment, showing a PD‐L1 score of 2% and FGFR2V395D and SMOW535L mutations. The patient progressed rapidly on anti‐PD1 immunotherapy. He was treated with the FGFR inhibitor, erdafitinib, with excellent partial response including resolution of intracranial disease and cancer‐related pain, ongoing 2 years after drug initiation. Conclusion Targeting the FGFR2 mutation resulted in sustained response and improved quality of life. Genomic profiling with targeted therapy for ameloblastoma appears promising, especially when surgery is technically infeasible.
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Affiliation(s)
- Katherine A. Lawson‐Michod
- UA Health Sciences University of Arizona (UA) Cancer Center Tucson Arizona USA
- Huntsman Cancer Institute University of Utah Health Salt Lake City Utah USA
| | - Christopher H. Le
- Department of Otolaryngology – Head & Neck Surgery UA College of Medicine‐Tucson Tucson Arizona USA
| | - Ghassan Tranesh
- Department of Pathology UA College of Medicine‐Tucson Tucson Arizona USA
| | - Penelope C. Thomas
- Department of Medical Imaging UA College of Medicine‐Tucson Tucson Arizona USA
| | - Julie E. Bauman
- UA Health Sciences University of Arizona (UA) Cancer Center Tucson Arizona USA
- Department of Medicine UA College of Medicine‐Tucson Tucson Arizona USA
- Division of Hematology/Oncology, Department of Medicine George Washington (GW) University and GW Cancer Center Washington District of Columbia USA
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Molecular biology exploration and targeted therapy strategy of Ameloblastoma. Arch Oral Biol 2022; 140:105454. [DOI: 10.1016/j.archoralbio.2022.105454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022]
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Narayan B, Urs AB, Augustine J, Singh H. Role of phosphatase and tensin homolog in pathogenesis of ameloblastoma: An immunohistochemical study. J Cancer Res Ther 2020; 16:513-516. [PMID: 32719259 DOI: 10.4103/jcrt.jcrt_528_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Altered molecular signaling pathways in ameloblastoma have been identified to play a pivotal role in the mechanism of oncogenesis, differentiation, and tumor progression. Phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway is one of the signaling pathways that are associated with the pathogenesis of ameloblastoma. Phosphatase and tensin homolog (PTEN) controls cell migration and proliferation. It monitors the level of the Akt and maintains cellular integrity. The present study was aimed to study the immunoexpression of PTEN in ameloblastoma to understand its role in the pathogenesis of ameloblastoma. Materials and Methods Twenty cases of ameloblastoma and ten cases of normal tooth germ were subjected to immunohistochemical staining against PTEN. Results Strong PTEN immunopositivity was seen in the tooth germs, while weak positivity was seen in the ameloblastoma. The immunoscore for PTEN was calculated by adding the percentage score and the intensity score. Seventeen cases showed the reduced PTEN expression in the epithelial component of ameloblastoma. The unpaired t-test showed a statistically significant difference in the mean PTEN immunoscore in tooth germ and ameloblastoma. Conclusion The study showed reduced PTEN immunoreactivity, which plays a role in the pathogenesis of ameloblastoma, through Akt pathway.
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Affiliation(s)
- Bhaskar Narayan
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Aadithya B Urs
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Jeyaseelan Augustine
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Hanspal Singh
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Jisha GB, Ilayaraja V, Yoithapprabhunath TR, Ganapathy N, Dineshshankar J, Nirmal RM. Immunohistochemical detection of Tyrosine Kinase receptor (TrK) in follicular and plexiform ameloblastoma - A novel study. J Oral Maxillofac Pathol 2020; 24:125-130. [PMID: 32508460 PMCID: PMC7269298 DOI: 10.4103/jomfp.jomfp_220_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/31/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives: The objective is to analyze the immunohistochemical expression pattern of tyrosine kinase receptor (TrK) in ameloblastoma and to compare the immunohistochemical expression pattern of TrK among the histological types of ameloblastoma, follicular and plexiform patterns. Materials and Methods: Forty ameloblastomas (20 follicular and 20 plexiform) were immunostained with anti-human TrK mouse IgG monoclonal antibody, and the pattern of staining is statistically analyzed. Results: Total 20 (4 follicular and 16 plexiform) out of 40 ameloblastomas showed immunoreactivity to TrK. Only the peripheral preameloblast like tall columnar cells showed reactivity, whereas the stellate reticulum like cells is immunonegative. The staining pattern was membranous in the immunoreactive cells. The Chi-square value for the immunoexpression between follicular and plexiform ameloblastoma was statistically significant with a P < 0.005. The results were studied with the downstream pathways from the literature, and a possible mechanism has been proposed. Conclusion: The expression pattern of TrK is found to be more in plexiform ameloblastoma than follicular ameloblastoma.
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Affiliation(s)
- George Babu Jisha
- Consultant Oral and Maxillofacial Pathologist, SM Dental Clinic, Erode, Tamil Nadu, India
| | - Vadivel Ilayaraja
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | | | - Nalliappan Ganapathy
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | - Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Namakkal, Tamil Nadu, India
| | - Ramadas Madhavan Nirmal
- Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Chidambaram, Tamil Nadu, India
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8
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Cadavid AMH, Araujo JP, Coutinho-Camillo CM, Bologna S, Junior CAL, Lourenço SV. Ameloblastomas: current aspects of the new WHO classification in an analysis of 136 cases. SURGICAL AND EXPERIMENTAL PATHOLOGY 2019. [DOI: 10.1186/s42047-019-0041-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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9
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Peralta S, McCleary-Wheeler AL, Duhamel GE, Heikinheimo K, Grenier JK. Ultra-frequent HRAS p.Q61R somatic mutation in canine acanthomatous ameloblastoma reveals pathogenic similarities with human ameloblastoma. Vet Comp Oncol 2019; 17:439-445. [PMID: 31041834 DOI: 10.1111/vco.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 12/11/2022]
Abstract
Ameloblastoma is a locally aggressive odontogenic tumour that occurs in humans and dogs. Most ameloblastomas (AM) in humans harbour mutually-exclusive driving mutations in BRAF, HRAS, KRAS, NRAS or FGFR2 that activate MAPK signalling, and in SMO that activates Hedgehog signalling. The remarkable clinical and histological similarities between canine acanthomatous ameloblastoma (CAA) and AM suggest they may harbour similar driving mutations. In this study, aimed at characterizing the mutational status of SMO, BRAF, HRAS, KRAS, NRAS and FGFR2 in CAA, we used RNA sequencing, Sanger sequencing and restriction fragment length polymorphism assays to demonstrate that 94% of CAA (n = 16) harbour a somatic HRAS p.Q61R mutation. The similarities in MAPK-activating mutational profiles between CAA and AM implicate conserved molecular mechanisms of tumorigenesis, thus, qualifying the dog as a potentially useful model of disease. Given the relevance of RAS mutations in the pathogenesis of odontogenic tumours and other types of cancer, the results of this study are of comparative, translational, and veterinary value.
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Affiliation(s)
- Santiago Peralta
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Angela L McCleary-Wheeler
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.,Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Gerald E Duhamel
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Kristiina Heikinheimo
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jennifer K Grenier
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.,RNA Sequencing Core, Cornell University, Ithaca, New York
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Genetic alteration of Exon 5 of the PTEN gene in Indian patients with ameloblastoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:225-230. [PMID: 30598407 DOI: 10.1016/j.oooo.2018.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/09/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The PI3K/Akt/mTOR pathway is one of the signaling pathways associated with the pathogenesis of ameloblastoma. The phosphatase and tensin (PTEN) homologue controls cell migration and proliferation. It monitors the level of Akt and maintains cellular integrity. The aim of the present study was to study the genetic alteration of Exon 5 of the PTEN gene in Indian patients with ameloblastoma. STUDY DESIGN Total DNA was extracted from formalin-fixed paraffin-embedded tissue samples from 20 cases with solid multicystic ameloblastoma (SMA) and from 10 cases with normal tooth germ. Exon 5 of the PTEN gene, was assessed for its role in the pathogenesis of ameloblastoma. RESULTS Five of 20 cases of SMA showed genetic alteration. Of these cases 3 (15%) showed silent mutation, 1 (5%) showed change in amino acid sequence from valine to glutamic acid, and 1 (5%) showed nonsense-mediated mRNA decay. CONCLUSIONS The present study showed 25% somatic mutational frequency in exonic region 5 of the PTEN gene. This may indicate its role in the pathogenesis of ameloblastoma.
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11
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Tenório JR, Santana T, Queiroz SIML, de Oliveira DHIP, Queiroz LMG. Apoptosis and cell cycle aberrations in epithelial odontogenic lesions: An evidence by the expression of p53, Bcl-2 and Bax. Med Oral Patol Oral Cir Bucal 2018; 23:e120-e125. [PMID: 29476674 PMCID: PMC5911354 DOI: 10.4317/medoral.22019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 12/23/2017] [Indexed: 01/27/2023] Open
Abstract
Background Ameloblastoma (AMB), odontogenic keratocyst (OKC) and adenomatoid odontogenic tumor (AOT) are epithelial odontogenic lesions with diverse biologic profiles. Defects in regulation of apoptosis and cell cycle may be involved in the development and progression of those lesions, therefore we aimed to investigate the expression of Bcl-2, Bax and p53 to better understand the possible role of these proteins in AMBs, OKCs and AOTs. Material and Methods The studied sample consisted of 20 AMBs, 20 OKCs and 20 AOTs. Immunohistochemistry technique was performed for the antibodies p53, Bcl-2 and Bax. Immunoreactivity was observed in the epithelial component and positive cells were counted in five fields (100x magnification). Statistical analysis was performed with Kruskal-Wallis and Spearman tests (p<0.05). Results All lesions exhibited staining for the three studied proteins. There was no statistically significant associations between the expression of proteins and the lesions, however we identified a positive correlation between the expression of p53 and Bcl-2 (r = 0.200) and a negative correlation between p53 and Bax expressions (r = -0.100). In addition, p53 and Bax were similarly expressed between AMBs and OKCs. Bcl-2 was similarly expressed in AMBs and AOTs. Conclusions Apoptosis regulatory proteins, as well as cell cycle proteins, are differently expressed in epithelial odontogenic lesions and their expression is possibly related to the biological behavior of AMB, OKC and AOT. Key words:Odontogenic tumors, apoptosis, apoptosis regulatory proteins, p53 tumor suppressor protein, immunohistochemistry.
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Affiliation(s)
- J-R Tenório
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000 Natal, RN, Brasil,
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Effiom OA, Ogundana OM, Akinshipo AO, Akintoye SO. Ameloblastoma: current etiopathological concepts and management. Oral Dis 2017; 24:307-316. [PMID: 28142213 DOI: 10.1111/odi.12646] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 02/06/2023]
Abstract
Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis. Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. Molecular and genetic factors that promote oncogenic transformation of odontogenic epithelium to ameloblastoma are strongly linked to dysregulation of multiple genes associated with mitogen-activated protein kinase, sonic hedgehog, and WNT/β-catenin signaling pathways. Treatment of ameloblastoma is focused on surgical resection with a wide margin of normal tissue because of its high propensity for locoregional invasion; but this is often associated with significant patient morbidity. The relatively high recurrence rate of ameloblastoma is influenced by the type of molecular etiological factors, the management approach, and how early the patient presents for treatment. It is expected that further elucidation of molecular factors that orchestrate pathogenesis and recurrence of ameloblastoma will lead to new diagnostic markers and targeted drug therapies for ameloblastoma.
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Affiliation(s)
- O A Effiom
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - O M Ogundana
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - A O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - S O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G. Ameloblastoma of the jaws: Management and recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:7-11. [DOI: 10.1016/j.anorl.2016.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ragunathan YT, Madhavan NR, Mohan SP, Kumar SK. Immunohistochemical Detection of p75 Neurotrophin Receptor (p75-NTR) in Follicular and Plexiform Ameloblastoma. J Clin Diagn Res 2016; 10:ZC63-6. [PMID: 27656566 DOI: 10.7860/jcdr/2016/17782.8280] [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] [Received: 11/19/2015] [Accepted: 02/08/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Ameloblastoma holds a unique position among benign tumours by its locally destructive and invasive nature. Recently improvised molecular techniques helped researchers to unravel the myth behind such biologic behaviour. Though interesting findings have been delivered, the rhythmic correlation regarding the exact mechanism still remains lacking. Neurotrophins and their receptor mediated pathways play a crucial role in survival, death and differentiation of many neuroectoderm derived cells. With this background, the study has been aimed to investigate the expression of p75-NTR (Neurotrophin Receptor) in follicular and plexiform ameloblastoma. AIM To analyze the immunohistochemical expression pattern of p75-NTR in ameloblastoma and to compare the immunohistochemical expression pattern of p75-NTR among the histological types of ameloblastoma, follicular and plexiform patterns. MATERIALS AND METHODS Total 22 ameloblastomas (12 follicular, 10 plexiform) were immuno-stained with anti-human p75-NTR mouse IgG monoclonal antibody and the pattern of staining is statistically analyzed. RESULTS Only 11 (10 follicular, 1 plexiform) out of 22 ameloblastomas showed immuno-reactivity to p75-NTR. In ameloblastoma, only the peripheral pre-ameloblast like tall columnar cells showed reactivity whereas the stellate reticulum-like cells were immuno-negative. The staining pattern was membranous in the immuno-reactive cells. The results were studied with the downstream pathways from the literature and a possible mechanism has been proposed. CONCLUSION The expression pattern of p75-NTR was found to be more in follicular ameloblastoma than plexiform.
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Affiliation(s)
| | - Nirmal Ramadas Madhavan
- Professor and Head, Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital , Tamilnadu, India
| | - Sunil Paramel Mohan
- Professor and Head, Department of Oral and Maxillofacial Pathology, Sree Anjaneya Institute of Dental Sciences , Kerela, India
| | - Srichinthu Kenniyan Kumar
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, K.S.R. Institute of Dental Science and Research , Tamilnadu, India
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Mishra P, Panda A, Bandyopadhyay A, Kumar H, Mohiddin G. Sonic Hedgehog Signalling Pathway and Ameloblastoma - A Review. J Clin Diagn Res 2015; 9:ZE10-3. [PMID: 26674664 DOI: 10.7860/jcdr/2015/15443.6750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/06/2015] [Indexed: 01/06/2023]
Abstract
Ameloblastoma is a benign but aggressive odontogenic neoplasm arising from odontogenic epithelium. Many theories have been proposed to explain the pathogenesis of ameloblatoma. Numerous signalling pathways have been implicated to be associated in the development and progression of this neoplasm. Studies have found association of various signalling molecules of Sonic Hedgehog Pathway, namely SHH, PTCH1, SMO, Gli 1, Gli 2, Gli 3, with ameloblastoma. Knowledge about this pathway will help us to understand the nature and behaviour of this neoplasm. This will open the door towards new treatment modalities.
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Affiliation(s)
- Pallavi Mishra
- Postgraduate Trainee, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental sciences, KIIT , Bhubaneswar, Odisha, India
| | - Abikshyeet Panda
- Reader, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT , Bhubaneswar, Odisha. India
| | - Alokenath Bandyopadhyay
- Professor and Head of the Department, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT , Bhubaneswar. Odisha. India
| | - Harish Kumar
- Professor, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT , Bhubaneswar, Odisha, India
| | - Gouse Mohiddin
- Reader, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT , Bhubaneswar, Odisha, India
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Antonoglou GN, Sándor GK. Recurrence rates of intraosseous ameloblastomas of the jaws: A systematic review of conservative versus aggressive treatment approaches and meta-analysis of non-randomized studies. J Craniomaxillofac Surg 2015; 43:149-57. [DOI: 10.1016/j.jcms.2014.10.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/08/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022] Open
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Mohan BC, Angadi PV. Quantitative and qualitative analysis of epidermal growth factor receptor expression in pericoronal follicles in predicting proliferative potential. Acta Odontol Scand 2014; 72:770-5. [PMID: 24844785 DOI: 10.3109/00016357.2014.906649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The odontogenic epithelium in pericoronal follicles (PFs) are known to proliferate to form cysts and tumors. This epithelium is mostly composed of the reduced enamel epithelium (REE) and odontogenic rests (OR). The objective of the present study was to evaluate the epidermal growth factor receptor (EGFR) immunoexpression in these PFs to assess their proliferative potential. STUDY DESIGN The immunoexpression of EGFR in 30 PFs were assessed by two independent observers for intensity, percentage and the location of the EGFR staining. RESULTS EGFR immunoexpression was noted in 100% of the follicles. A greater proportion of the follicles showed strong intensity (70%). It was noted that nearly 54% of the follicles demonstrated more than 50% of cells with EGFR immunolabelling. EGFR showed combined cytoplasm and membrane staining (40%) and cytoplasm only staining (37%). The analysis of the REE and OR individually for the above-mentioned parameters did not show statistical significance. CONCLUSION The increased intensity and overall positivity of the epithelium in follicles shows that odontogenic epithelium is responsive to EGFR mediated growth factors. The predominant combined staining pattern is suggestive of increased potential for the epithelium to undergo cystic or neoplastic proliferation.
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Affiliation(s)
- Bhavna C Mohan
- Department of Oral Pathology and Microbiology, Annoor Dental College , Mavattupuzzha, Kerala , India
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Activation of the Akt/mTOR pathway in dentigerous cysts, odontogenic keratocysts, and ameloblastomas. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:336-42. [PMID: 23953418 DOI: 10.1016/j.oooo.2013.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/11/2013] [Accepted: 06/14/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the Akt/mTOR pathway in dentigerous cysts (DCs), odontogenic keratocysts (OKCs), and ameloblastomas. STUDY DESIGN A total of 90 cases were studied (30 DCs, 30 OKCs, and 30 ameloblastomas). Patient records on age, sex, lesion location, symptoms, and radiographic and histopathologic features were collected. The phosphorylation of components of the Akt/mTOR pathway [p-Akt (Ser473), p-Akt (Thr308), and phosphorylated-ribosomal protein S6 (p-RPS6)] was studied using immunohistochemistry. Correlations with clinical features were analyzed using the Spearman rank test. RESULTS Over 90% of OKCs and ameloblastomas and 60% of DCs stained positive for p-Akt (Ser473). Phospho-Akt (Thr308) was positive in 73% of ameloblastomas, 40% of OKCs, and 20% of DCs. Phospho-RPS6 was detected most frequently in OKCs (83%), followed by ameloblastomas (76%) and DCs (53%). No correlations were noted between the immunohistochemical findings and the clinicopathologic parameters. CONCLUSIONS The Akt/mTOR pathway is upregulated in DCs, OKCs, and ameloblastomas. This pathway may be involved in the development of these lesions.
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Scheper MA, Duarte ECB, Intapa C, Zhang M, Nascimento LM, Almeida TP, Gomes AC, Song S, Chaisuparat R, Batista AC, Jham BC. Expression of midkine in ameloblastomas and its correlation with clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:497-502. [PMID: 22986245 DOI: 10.1016/j.oooo.2012.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 06/14/2012] [Accepted: 06/16/2012] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Midkine (MK) is a heparin-binding growth factor that is overexpressed in various human cancers. The aim of this study was to investigate the expression of MK in ameloblastomas and correlate the results with clinicopathologic parameters. STUDY DESIGN Cases of ameloblastoma seen between 1999 and 2010 were identified. Clinical information was collected regarding age, gender, race, and location of tumor. Cases were classified as solid/multicystic, unicystic, and peripheral. The expression of midkine was assessed using immunohistochemistry. A significant difference was considered present at P < 0.05. RESULTS A total of 34 cases of ameloblastoma and 4 cases of ameloblastic carcinomas were identified. MK was expressed in 67% of lesions (23.5% weak expression; 14.7% moderate expression; 29.4% strong expression). A significant difference was seen between solid/multicystic and unicystic lesions. CONCLUSIONS MK is expressed in the majority of ameloblastomas, suggesting a role of the protein in the tumor's development, progression, and behavior.
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Affiliation(s)
- Mark A Scheper
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Maryland, USA
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Schiavo G, D'Antò V, Cantile M, Procino A, Di Giovanni S, Valletta R, Terracciano L, Baumhoer D, Jundt G, Cillo C. Deregulated HOX genes in ameloblastomas are located in physical contiguity to keratin genes. J Cell Biochem 2012; 112:3206-15. [PMID: 21732412 DOI: 10.1002/jcb.23248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The expression of the HOX gene network in mid-stage human tooth development mostly concerns the epithelial tooth germ compartment and involves the C and D HOX loci. To further dissect the HOX gene implication with tooth epithelium differentiation we compared the expression of the whole HOX network in human ameloblastomas, as paradigm of epithelial odontogenic tumors, with tooth germs. We identified two ameloblastoma molecular types with respectively low and high number of active HOX C genes. The highly expressing HOX C gene ameloblastomas were characterized by a strong keratinized phenotype. Locus C HOX genes are located on chromosome 12q13-15 in physical contiguity with one of the two keratin gene clusters included in the human genome. The most posterior HOX C gene, HOX C13, is capable to interact with hair keratin genes located on the other keratin gene cluster in physical contiguity with the HOX B locus on chromosome 17q21-22. Inside the HOX C locus, a 2.2 kb ncRNA (HOTAIR) able to repress transcription, in cis, along the entire HOX C locus and, in trans, at the posterior region of the HOX D locus has recently been identified. Interestingly both loci are deregulated in ameloblastomas. Our finding support an important role of the HOX network in characterizing the epithelial tooth compartment. Furthermore, the physical contiguity between locus C HOX and keratin genes in normal tooth epithelium and their deregulation in the neoplastic counterparts suggest they may act on the same mechanism potentially involved with epithelial tumorigenesis.
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Affiliation(s)
- Giulia Schiavo
- Institute of Pathology-Molecular Pathology Division, University of Basel, Schonbeinstrasse 40, 4031 Basel, Switzerland
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Nthumba PM. Squamous cell carcinoma (Marjolin's ulcer) in an orocutaneous fistula of a large mandibular ameloblastoma: a case report. J Med Case Rep 2011; 5:396. [PMID: 21854569 PMCID: PMC3173382 DOI: 10.1186/1752-1947-5-396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 08/19/2011] [Indexed: 11/30/2022] Open
Abstract
Introduction Ameloblastomas are rare lesions constituting 1% of all jaw tumors. Oral squamous cell carcinomas are common lesions; these constitute about 90% of all oral cancers. Concurrent tumors consisting of ameloblastoma and squamous cell carcinoma are extremely rare. Case presentation This case report describes a 35-year-old African man who presented with a large mandibular tumor with an orocutaneous fistula that was found to be an ameloblastoma on histopathological examination, with concurrent squamous cell carcinoma histology within the fistula. This presentation was consistent with a Marjolin's ulcer within an ameloblastoma. Conclusion Ameloblastomas and Marjolin's ulcers require different management strategies. Careful histopathological examination of surgical specimens is key to patient outcome, as treatment of these patients depends on an accurate diagnosis.
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Affiliation(s)
- Peter M Nthumba
- Plastic, Reconstructive and Hand Unit, AIC Kijabe Hospital, Kijabe 00220, Kenya.
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Ameloblastomas have already been treated successfully with intralesional chemotherapy in dogs, why not in humans? Oral Oncol 2011; 48:e1. [PMID: 21821463 DOI: 10.1016/j.oraloncology.2011.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 07/07/2011] [Accepted: 07/09/2011] [Indexed: 11/21/2022]
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