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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.
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Nimmanagoti R, Nandan SRK, Kulkarni PG, Reddy SP, Keerthi M, Pupala G. Protein 53, B-Cell Lymphoma-2, Cyclooxygenase-2, and CD105 Reactivity in Keratocystic Odontogenic Tumors: An Immunohistochemical Analysis. Int J Appl Basic Med Res 2019; 9:27-31. [PMID: 30820416 PMCID: PMC6385539 DOI: 10.4103/ijabmr.ijabmr_138_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 01/02/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective is to evaluate and compare immunohistochemically, the biological behavior of keratocystic odontogenic tumor (KCOT) with normal oral mucosa by analyzing cell proliferation, angiogenesis, and antiapoptosis using cyclooxygenase-2 (COX-2), protein 53 (p53), B-cell lymphoma-2 (Bcl-2), and CD105 (endoglin). MATERIALS AND METHODS The present study comprised 30 cases of KCOT in the study group, in which the expression of COX-2, p53, Bcl-2, and CD105 were analyzed and compared with that of control group consisting of 30 normal oral mucosae. RESULTS The results were evaluated based on a number of positively stained cells; among 30 samples of KCOT, 22 samples were p53 positive, 23 samples were Bcl-2 positive, 18 samples were COX-2 positive, whereas all the above markers were negative in all the 30 samples of the normal oral mucosa and CD105 mean vascular density in KCOT 13.8 in normal oral mucosa. CONCLUSION The present study suggests that angiogenesis, cell proliferation, and antiapoptosis may be the possible factors contributing for the unique biological behavior of KCOT.
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Affiliation(s)
- Ravi Nimmanagoti
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - SRK Nandan
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Pavan G. Kulkarni
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Shyam Prasad Reddy
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - M. Keerthi
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Gouri Pupala
- Department of Oral pathology & Maxillofacial, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
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Fatemeh M, Sepideh A, Sara BS, Nazanin M. P53 Protein Expression in Dental Follicle, Dentigerous Cyst, Odontogenic Keratocyst, and Inflammatory Subtypes of Cysts: An Immunohistochemical Study. Oman Med J 2017; 32:227-232. [PMID: 28584604 DOI: 10.5001/omj.2017.42] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. METHODS Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). RESULTS The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant (p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. CONCLUSIONS The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression.
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Affiliation(s)
- Mashhadiabbas Fatemeh
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arab Sepideh
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagheri Seyedeh Sara
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahdavi Nazanin
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Ledderhof NJ, Caminiti MF, Bradley G, Lam DK. Topical 5-Fluorouracil is a Novel Targeted Therapy for the Keratocystic Odontogenic Tumor. J Oral Maxillofac Surg 2016; 75:514-524. [PMID: 27789270 DOI: 10.1016/j.joms.2016.09.039] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE The antimetabolite drug, 5-fluorouracil (5-FU), is used in the treatment of various cancers, including basal cell carcinomas (BCCs). The authors hypothesized that keratocystic odontogenic tumors (KOTs) would respond to 5-FU treatment because of their similarities to BCCs in molecular etiopathogenesis. MATERIALS AND METHODS An ambispective cohort study of the treatment efficacy of topical 5-FU on KOTs was conducted. Independent variables included the topical application of 5% 5-FU or modified Carnoy's solution (MC) after enucleation and peripheral ostectomy at the University of Toronto from 2006 through 2014. Outcome variables included time to recurrence and peripheral nerve injury. KOT specimens in these patients were immunostained with p53, Ki-67, thymidylate synthetase (TS), thymidylate phosphorylase (TP), and dihydropyrimidine dehydrogenase (DPD) antibodies. Semiquantitative staining scores were calculated for all immunohistochemistry sections examined. Descriptive statistics were computed using Fisher exact test and Kaplan-Meier analysis as appropriate with the P value set at .05. RESULTS Thirty-two patients with 32 KOTs were reviewed (41% in women and 59% in men). There were no KOT recurrences in the 5-FU group (n = 11), whereas there were 4 recurrences in the MC group (n = 21; P = .190). There was a significantly lower incidence of inferior alveolar nerve paresthesia with 5-FU treatment (P = .039). Immunohistochemical staining showed upregulation of TP (P < .0001) and DPD (P < .0001) and no change in TS (P > .05) in inflamed KOTs. CONCLUSIONS 5-FU effectively treats KOTs with less postoperative morbidity than conventional treatment with MC. Low TS and upregulated TP expressions in inflamed KOTs suggest increased 5-FU efficacy in inflamed KOTs. Topical 5-FU is a novel therapy for KOTs and provides a targeted molecular approach to treatment.
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Affiliation(s)
- Nicholas J Ledderhof
- Chief Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Marco F Caminiti
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Toronto, Toronto, ON, Canada
| | - Grace Bradley
- Professor and Head, Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - David K Lam
- Assistant Professor and Head, Department of Oral and Maxillofacial Surgery, University of Toronto, Toronto, ON, Canada.
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Hu S, Divaris K, Parker J, Padilla R, Murrah V, Wright JT. Transcriptome Variability in Keratocystic Odontogenic Tumor Suggests Distinct Molecular Subtypes. Sci Rep 2016; 6:24236. [PMID: 27066764 PMCID: PMC4828651 DOI: 10.1038/srep24236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/23/2016] [Indexed: 01/02/2023] Open
Abstract
Keratocystic Odontogenic Tumor (KCOT) is a locally aggressive developmental cystic neoplasm thought to arise from the odontogenic epithelium. A high recurrence rate of up to 30% has been found following conservative treatment. Aggressive tumor resection can lead to the need for extensive reconstructive surgery, resulting in significant morbidity and impacting quality of life. Most research has focused on candidate-genes with a handful of studies employing whole transcriptome approaches. There is also the question of which reference tissue is most biologically-relevant. This study characterizes the transcriptome of KCOT using whole genome microarray and compare it with gene expression of different odontogenic tissues (“dentome”). Laser capture microdissection was used to isolate the neoplastic epithelial tissue in 20 cases. KCOT gene expression was compared with the “dentome” and relevant pathways were examined. Cluster analysis revealed 2 distinct molecular subtypes of KCOT. Several inflammatory pathways were activated in both subtypes. The AKT pathway was activated in one subtype while MAP kinase pathway was activated in the other. Additionally, PTCH1 expression was downregulated in both clusters suggesting involvement in KCOT tumorigenesis. In conclusion, this study provides new insights into the transcriptome of KCOT and highlights pathways that could be of diagnostic and prognostic value.
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Affiliation(s)
- Shijia Hu
- Pediatric Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Faculty of Dentistry, National University of Singapore, Singapore
| | - Kimon Divaris
- Pediatric Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Joel Parker
- Cancer Genetics, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Ricardo Padilla
- Diagnostic Sciences, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Valerie Murrah
- Diagnostic Sciences, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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Santos EMS, Santos HO, dos Santos Dias I, Santos SH, Batista de Paula AM, Feltenberger JD, Sena Guimarães AL, Farias LC. Bioinformatics Analysis Reveals Genes Involved in the Pathogenesis of Ameloblastoma and Keratocystic Odontogenic Tumor. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2016; 5:199-219. [PMID: 28357197 PMCID: PMC5353982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/10/2016] [Indexed: 11/05/2022]
Abstract
Pathogenesis of odontogenic tumors is not well known. It is important to identify genetic deregulations and molecular alterations. This study aimed to investigate, through bioinformatic analysis, the possible genes involved in the pathogenesis of ameloblastoma (AM) and keratocystic odontogenic tumor (KCOT). Genes involved in the pathogenesis of AM and KCOT were identified in GeneCards. Gene list was expanded, and the gene interactions network was mapped using the STRING software. "Weighted number of links" (WNL) was calculated to identify "leader genes" (highest WNL). Genes were ranked by K-means method and Kruskal-Wallis test was used (P<0.001). Total interactions score (TIS) was also calculated using all interaction data generated by the STRING database, in order to achieve global connectivity for each gene. The topological and ontological analyses were performed using Cytoscape software and BinGO plugin. Literature review data was used to corroborate the bioinformatics data. CDK1 was identified as leader gene for AM. In KCOT group, results show PCNA and TP53. Both tumors exhibit a power law behavior. Our topological analysis suggested leader genes possibly important in the pathogenesis of AM and KCOT, by clustering coefficient calculated for both odontogenic tumors (0.028 for AM, zero for KCOT). The results obtained in the scatter diagram suggest an important relationship of these genes with the molecular processes involved in AM and KCOT. Ontological analysis for both AM and KCOT demonstrated different mechanisms. Bioinformatics analyzes were confirmed through literature review. These results may suggest the involvement of promising genes for a better understanding of the pathogenesis of AM and KCOT.
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Affiliation(s)
- Eliane Macedo Sobrinho Santos
- Department of Dentistry, Universidade Estadual de Montes Claros, Minas Gerais, Brazil.,Instituto Federal do Norte de Minas Gerais-Campus Araçuaí, Minas Gerais, Brazil.
| | | | | | | | | | | | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Minas Gerais, Brazil.,Corresponding author: Universidade Estadual de Montes Claros Hospital Universitário Clemente de Faria Laboratório de Pesquisa em Saúde Avenida Cula Mangabeira, 562 Montes Claros, Minas Gerais, Brasil. E-mail:
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