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Noda Y, Sawada S, Sakagami T, Kojima Y, Higasa K, Tsuta K. Adenoid Ameloblastoma with BRAF p.V600E Mutation Revealing Ameloblastomatous Origin: A First Case Report. Head Neck Pathol 2023; 17:788-792. [PMID: 37093491 PMCID: PMC10514000 DOI: 10.1007/s12105-023-01555-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Adenoid ameloblastoma (AdAM) is a frequently recurrent tumor that shows hybrid histological features of both ameloblastoma and adenomatoid odontogenic tumor (AOT). AdAM is expected to be classified as a new subtype of ameloblastoma in the next revision of the World Health Organization (WHO) odontogenic tumor classification. However, whether AdAM is a histologic variant of ameloblastoma or AOT remains unclear. To establish a new category, genetic evidence indicating the tumor category is necessary. METHODS We present a case of a 23-year-old Japanese woman with AdAM who underwent genetic/DNA analysis for ameloblastoma-related mutation using immunohistochemical staining, Sanger sequencing, and next-generation sequencing (NGS) analyses with reliable clinicopathological evidence. RESULTS Immunohistochemical expression of BRAF p.V600E was diffusely positive for both ameloblastoma- and AOT-like components. Sanger sequencing and NGS analyses showed missense mutations in BRAF p.V600E (c.1799T > A), a gene that is commonly altered in ameloblastomas but not in KRAS, another gene associated with AOT. CONCLUSION This case report is the first to provide genetic evidence on the ameloblastomatous origin of AdAM with a BRAF p.V600E mutation. A larger series of AdAM groups' molecular testing is needed to aptly classify them and prognosticate the best treatment.
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Affiliation(s)
- Yuri Noda
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hospital, 2-3-1 Shin-Machi, Hirakata, Osaka, 573-1191, Japan.
- Department of Pathology, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan.
| | - Shunsuke Sawada
- Department of Dentistry and Oral Surgery, Kansai Medical University Hospital, 2-3-1 Shin-Machi, Hirakata, Osaka, 573-1191, Japan
| | - Tomofumi Sakagami
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hospital, 2-3-1 Shin-Machi, Hirakata, Osaka, 573-1191, Japan
| | - Yuka Kojima
- Department of Dentistry and Oral Surgery, Kansai Medical University Hospital, 2-3-1 Shin-Machi, Hirakata, Osaka, 573-1191, Japan
| | - Koichiro Higasa
- Department of Genome Analysis, Institute of Biomedical Science, Kansai Medical University, 2-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Koji Tsuta
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hospital, 2-3-1 Shin-Machi, Hirakata, Osaka, 573-1191, Japan
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2
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CDC7 Expression in Selected Odontogenic Tumors. Int J Dent 2022; 2022:6336003. [DOI: 10.1155/2022/6336003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives. CDC7 is a serine-threonine kinase that plays a key role in initiating DNA replication. It has been implicated in the growth and invasion of many pathologic lesions and suggested as a diagnostic marker. The aim of this study was to evaluate CDC7 in some odontogenic tumors. Materials and Methods. In this cross-sectional study, 45 cases, including 19 ameloblastomas, 15 dentigerous cysts, 7 ameloblastic fibromas, and 4 adenomatoid odontogenic tumors (AOT), were studied immunohistochemically. ANOVA and post hoc methods were used for statistical analysis. Results. CDC7 expression was observed in 93% of tumors and all dentigerous cysts. The expression rate was low. The results showed a higher expression rate of CDC7 in ameloblastoma and ameloblastic fibroma compared to AOT (
and
, respectively). Ameloblastoma and ameloblastic fibroma were not significantly different in CDC7 expression (
). Conclusion. According to the results, the expression of the CDC7 protein in odontogenic tumors is low. The higher expression of CDC7 in ameloblastoma and ameloblastic fibroma in comparison with AOT confirms the hamartomatous growth of the latter, so it can be considered as a potential diagnostic marker. Future studies with a larger sample size are suggested to obtain a cut-off point for diagnostic purposes.
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3
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Marín C, Niklander SE, Martínez-Flores R. Genetic Profile of Adenomatoid Odontogenic Tumor and Ameloblastoma. A Systematic Review. FRONTIERS IN ORAL HEALTH 2022; 2:767474. [PMID: 35048068 PMCID: PMC8757772 DOI: 10.3389/froh.2021.767474] [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: 08/30/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To perform a comprehensive and systematic critical appraisal of the genetic alterations reported to be present in adenomatoid odontogenic tumor (AOT) compared to ameloblastoma (AM), to aid in the understanding in their development and different behavior. Methods: An electronic search was conducted in PubMed, Scopus, and Web of Science during March 2021. Eligibility criteria included publications on humans which included genetic analysis of AOT or AM. Results: A total of 43 articles reporting 59 AOTs and 680 AMs were included. Different genomic techniques were used, including whole-exome sequencing, direct sequencing, targeted next-generation sequencing panels and TaqMan allele-specific qPCR. Somatic mutations affecting KRAS were identified in 75.9% of all AOTs, mainly G12V; whereas a 71% of the AMs harbored BRAF mutations, mainly V600E. Conclusions: The available genetic data reports that AOTs and AM harbor somatic mutations in well-known oncogenes, being KRAS G12V/R and BRAFV600E mutations the most common, respectively. The relatively high frequency of ameloblastoma compared to other odontogenic tumors, such as AOT, has facilitated the performance of different sequencing techniques, allowing the discovery of different mutational signatures. On the contrary, the low frequency of AOTs is an important limitation for this. The number of studies that have a assessed the genetic landscape of AOT is still very limited, not providing enough evidence to draw a conclusion regarding the relationship between the genomic alterations and its clinical behavior. Thus, the presence of other mutational signatures with clinical impact, co-occurring with background KRAS mutations or in wild-type KRAS cases, cannot be ruled out. Since BRAF and RAS are in the same MAPK pathway, it is interesting that ameloblastomas, frequently associated with BRAFV600E mutation have aggressive clinical behavior, but in contrast, AOTs, frequently associated with RAS mutations have indolent behavior. Functional studies might be required to solve this question.
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Affiliation(s)
- Constanza Marín
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile.,Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
| | - Sven E Niklander
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile
| | - René Martínez-Flores
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile
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4
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Jabbarzadeh M, Hamblin MR, Pournaghi-Azar F, Vakili Saatloo M, Kouhsoltani M, Vahed N. Ki-67 expression as a diagnostic biomarker in odontogenic cysts and tumors: A systematic review and meta-analysis. J Dent Res Dent Clin Dent Prospects 2021; 15:66-75. [PMID: 33927844 PMCID: PMC8058158 DOI: 10.34172/joddd.2021.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/30/2020] [Indexed: 01/11/2023] Open
Abstract
Ki-67 is a marker of cell proliferation, used as an important diagnostic marker in the pathologic differentiation of various lesions. It is also relevant for developing targeted molecular therapies. We carried out a systematic review to assess the Ki-67 labeling index (LI) in odontogenic cysts and tumors. Databases were searched, including PubMed (MEDLINE), Scopus, CINHAL, PsycoInfo, the Cochrane Library, and Proquest. The meta-analysis was carried out based on the data of 608 lesions. When a 5% cut-off point was set, ki-67 LI of all benign odontogenic tumors dropped below this point. All the malignant tumors demonstrated an LI of over 15.3%; a significantly higher Ki-67 LI in malignant odontogenic lesions (17.59±2.80) was observed. Among benign tumors, the largest and the smallest Ki-67 LIs were seen in ameloblastoma (4.39±0.47) and adenomatoid odontogenic tumor (0.91±1.71). The mean values of Ki-67 LI in tumors and cysts were 4.23 (0.38) and 1.04 (0.07), respectively. Among odontogenic cysts, the highest Ki-67 LI was found in odontogenic keratocyst (OKC) (3.58±0.51), and the lowest in the radicular cyst (1.29±0.62%). Ki-67 LIs in all odontogenic cysts were <3%, except for OKC. This controversial lesion seems to have a profile more similar to a tumor, and a treatment plan similar to tumors might be suggested. We found that odontogenic lesions have diverse proliferative activities that help differentiate between various lesions and suggest therapeutic plans.
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Affiliation(s)
- Mahnaz Jabbarzadeh
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa
| | - Fatemeh Pournaghi-Azar
- Department of Restorative Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maedeh Vakili Saatloo
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Urmia University of Medical Sciences, Urmia, Iran
| | - Maryam Kouhsoltani
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafiseh Vahed
- Research Center for Evidence-based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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5
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Manohar B, Verma N, Mannan N, Bhuvaneshwari S. Adenomatoid odontogenic tumor mimicking a lateral periodontal cyst - A rare case report in the mandible. J Indian Soc Periodontol 2020; 24:473-476. [PMID: 33144777 PMCID: PMC7592615 DOI: 10.4103/jisp.jisp_79_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/15/2020] [Accepted: 06/11/2020] [Indexed: 11/04/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is benign tumor of the oral cavity characterized by its slow growth accounting to 3%-7% of the odontogenic tumors. AOTs mostly occur in the maxillary anterior region and most often than not associated with impacted anterior teeth. It affects the younger age group, especially below 20 years and is commonly seen in females. It occurs as two main variants - (a) central/intraosseous which is more common and (b) peripheral which is rare. The location of the lesion, its association with the impacted tooth, is the basis for the classification of AOT. The intraosseous type may be related to unerupted tooth (follicular variant) or may not be related to unerupted tooth (extra-follicular variant). Radiologically, AOT presents predominantly as a unilocular cystic lesion enclosing the unerupted tooth. The lesion presents rarely with a cystic component. Radiopacities on the intraoral periapical radiograph are seen as discrete foci having a flocculent pattern within radiolucency even with the presence of minimal calcified deposits. AOT being benign in nature is enucleated with least chances of recurrence. Here, we present a rare case of extra-follicular variant of adenomatoid odontogenic tumor in a 19-year-old female patient.
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Affiliation(s)
- Balaji Manohar
- Department of Periodontology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Neha Verma
- Private Practitioner, Ahmedabad, Gujarat, India
| | - Neha Mannan
- Department of Periodontology, Pacific Dental College Research Institute, Udaipur, Rajasthan, India
| | - S Bhuvaneshwari
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
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6
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Orikpete EV, Omoregie OF, Ojo MA. Proliferative and anti-apoptotic indices of unicystic ameloblastoma, odontogenic keratocyst, dentigerous cyst and radicular cyst. J Oral Maxillofac Pathol 2020; 24:399. [PMID: 33456257 PMCID: PMC7802867 DOI: 10.4103/jomfp.jomfp_289_19] [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: 10/02/2019] [Revised: 05/16/2020] [Accepted: 07/06/2020] [Indexed: 12/03/2022] Open
Abstract
Objective: The aim of this study is to compare the proliferative capacity and antiapoptotic capacity of unicystic ameloblastoma (UA), odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) by assessing the Ki-67 labeling index (LI) and Bcl-2 LI, respectively. Materials and Methods: Formalin-fixed, paraffin-embedded tissue blocks of twenty-three histopathologically diagnosed UAs, 6 OKCs, 8 DCs and 10 RCs were selected from the archival specimens. Five micrometer thick sections of tissue blocks of the lesions were processed for immunohistochemical staining with Ki-67 and Bcl-2. The Ki-67 LI and Bcl-2 LI were determined for the cases with a positive reaction. Results: Ki-67 expression was seen in 6 (26.1%) cases of UA, 4 (66.7%) OKC, 1 (12.5%) DC and 1 (10.0%) RC. There was a statistically significant difference between the mean Ki-67 LI of UA and OKC (P = 0.024). Bcl-2 expression was seen in 16 (69.6%) UA, 5 (83.3%) OKC, 5 (62.5%) DC and 5 (50.0%) RC. The mean Bcl-2 LI of UA was significantly higher than that of DC (P = 0.048). Furthermore, cases of OKC had significantly higher mean Bcl-2 LI compared to DC (P = 0.026) and RC (P = 0.049). Conclusion: This study suggests that the Ki-67 LI may help in differentiating OKC from UA. The Bcl-2 LI may be useful in differentiating UA from DCs, and differentiating OKC from DC and RC.
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Affiliation(s)
- Efetobo Victor Orikpete
- Department of Oral Pathology and Oral Biology, Faculty of Dentistry, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Osawe Felix Omoregie
- Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, University of Benin, Benin City, Edo State, Nigeria
| | - Michael Akin Ojo
- Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, University of Benin, Benin City, Edo State, Nigeria
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7
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Iqbal A, Tamgadge S, Tamgadge A, Pereira T, Kumar S, Acharya S, Jadhav A. Evaluation of Ki-67 Expression in Oral Submucous Fibrosis and Its Correlation with Clinical and Histopathological Features. J Microsc Ultrastruct 2019; 8:20-24. [PMID: 32166060 PMCID: PMC7045623 DOI: 10.4103/jmau.jmau_28_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows atrophic epithelium, it has a high proliferative capacity. Therefore, this study correlates the Ki-67. (The name “ki” is derived from the city of origin [Kiel, Germany] expression with functional grading and epithelial thickness in OSMF). Methods: The study group comprised of thirty patients of OSMF, divided randomly into Group A, Group B, Group C, and Group D as per mouth opening (functional staging). Five participants without OSMF formed the negative control group. The positive control group comprised of five patients of diagnosed cases of squamous cell carcinoma. All the sections of biopsy were subjected for hematoxylin and eosin and immunohistochemistry staining and observed for expression of Ki-67. Epithelial thickness was evaluated using image analysis software of Leica research microscope. Images were analyzed by three independent observers who were blindfolded. All the findings were tabulated and statistically analyzed. Results: In the present study, as the functional staging increased, the Ki-67 expression also increased. Ki-67 expression was highest in severe functional staging/severely decreased mouth opening (100.78) and is least in mild functional staging/mild decreased mouth opening (10.39). However, there was no significant correlation between epithelial thickness and functional staging/mouth opening (P > 0.05). Conclusion: A decrease in functional staging (mouth opening) showed a greater expression of Ki-67, and there was no significant correlation between functional staging and epithelial thickness.
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Affiliation(s)
- Asif Iqbal
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Sandhya Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Avinash Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Treville Pereira
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Sourab Kumar
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Siddarth Acharya
- Department of Public Health Dentistry, D. Y. Patil University School of Dentistry, Nerul, Navi Mumbai, Maharashtra, India
| | - Abhishek Jadhav
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
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8
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Histopathological analysis of the differential diagnosis of peripheral odontogenic fibroma from fibrous epulis. J Oral Biosci 2019; 61:221-225. [PMID: 31669716 DOI: 10.1016/j.job.2019.10.003] [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: 09/02/2019] [Revised: 09/28/2019] [Accepted: 10/02/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Peripheral odontogenic fibroma (POF) is a relatively rare odontogenic tumor of the gingiva. Although its histological differential diagnosis from fibrous epulis (FE) is important, no study has reported the differences in their expression of immunohistochemical markers. Here, we compared the expression of tumor markers that are frequently used for the differential diagnosis of fibroproliferative lesions between POF and FE. METHODS Forty cases were selected, including 20 POF and 20 FE cases. CD34, B cell lymphoma (Bcl)-2, and Ki-67 were used as markers for immunohistochemical examination. The positive cell ratio was calculated, and Mann-Whitney U test was performed for statistical analysis. RESULTS POF and FE were negative for CD34 expression but showed Bcl-2 and Ki-67 expression. The ratio of Bcl-2- and Ki-67-positive cells was significantly higher in POF than in FE (p < 0.001). CONCLUSIONS POF is CD34 negative, and Bcl-2 and Ki-67 positive-cell ratio differs between POF and FE, suggesting that these proteins may serve as immunohistochemical markers for the differential diagnosis of POF.
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9
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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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10
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Siwach P, Joy T, Tupkari J, Thakur A. Controversies in Odontogenic Tumours: Review. Sultan Qaboos Univ Med J 2017; 17:e268-e276. [PMID: 29062548 DOI: 10.18295/squmj.2017.17.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/15/2017] [Accepted: 05/25/2017] [Indexed: 11/16/2022] Open
Abstract
Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.
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Affiliation(s)
- Pooja Siwach
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Tabita Joy
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Jagdish Tupkari
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Arush Thakur
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
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11
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Reichart PA, Philipsen HP, Khongkhunthian P, Sciubba JJ. Immunoprofile of the adenomatoid odontogenic tumor. Oral Dis 2016; 23:731-736. [DOI: 10.1111/odi.12572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/04/2016] [Accepted: 08/12/2016] [Indexed: 01/01/2023]
Affiliation(s)
- PA Reichart
- Department of Oral Medicine, Dental Radiology and Oral Surgery, CC03; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | | | - P Khongkhunthian
- Faculty of Dentistry; Center of Excellence for Dental Implantology; Chiang Mai University; Chiang Mai Thailand
| | - JJ Sciubba
- The Milton J. Dance Head and Neck Center; The Greater Baltimore Medical Center; Baltimore USA
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12
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Singh T, Chandu A, Clement J, Angel C. Immunohistochemistry of Five Molecular Markers for Typing and Management of Ameloblastomas: A Retrospective Analysis of 40 Cases. J Maxillofac Oral Surg 2016; 16:65-70. [PMID: 28286387 DOI: 10.1007/s12663-016-0923-5] [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: 03/10/2015] [Accepted: 05/21/2016] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The aims of this study are to elucidate if molecular markers can be used to differentiate between the two main types of ameloblastoma (unicystic and solid/multicystic), and to determine whether a biologically 'less-aggressive' subtype exists. METHODS A retrospective analysis of 33 solid/multicystic ameloblastomas and six unicystic ameloblastomas was completed using immunohistochemistry for five molecular markers: P16, P53, MMP-9, Survivin, and Ki-67. Tumors were graded as either negative or positive (mild, moderate, strong), and the results were related to both ameloblastoma subtypes and outcomes following treatment. RESULTS Unicystic ameloblastomas were more likely to test strongly positive for P53 than solid/multicystic ameloblastomas (p < 0.05), whereas the latter were more likely to be negative for Survivin (p < 0.05). Solid/multicystic and Type 3 unicystic ameloblastomas that were positive for P16, but also negative for MMP-9 and Survivin, were less likely to recur than all other tumors (p < 0.05). The proliferation index of an ameloblastic carcinoma (11 %) was shown to be higher than benign ameloblastomas (4.5 %). CONCLUSIONS Immunohistochemistry can be valuable in lesions where histological sub-typing of an ameloblastoma is unclear. A biologically 'less-aggressive' subtype may exist, and hence further research into this area is required.
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Affiliation(s)
- Thasvir Singh
- Oral and Maxillofacial Surgery Office C/- 2 North, Royal Melbourne Hospital, Parkville, VIC 3050 Australia.,Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3053 Australia
| | - Arun Chandu
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3053 Australia
| | - John Clement
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3053 Australia
| | - Christopher Angel
- Peter MacCallum Cancer Centre, East Melbourne, St Andrews Place, East Melbourne, VIC 3002 Australia
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13
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Khalele BA, Al-Shiaty RA. A novel marker of ameloblastoma and systematic review of immunohistochemical findings. Ann Diagn Pathol 2016; 22:18-24. [DOI: 10.1016/j.anndiagpath.2016.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/23/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022]
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14
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Abstract
The majority of oral diseases present as growths and masses of varied cellular origin. Such masses may include simple hyperplasia, hamartoma, choristoma, teratoma, benign or malignant neoplasms. The distinguishing features of hamartomatous lesions are not certain, and often these non-neoplastic masses are indiscreetly denoted as neoplasms without weighing their pathology or biological behaviour. Essentially, understanding the dynamics of each of these disease processes forms an integral part of the appropriate treatment planning.
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Affiliation(s)
- Shankargouda Patil
- Department of Oral Pathology and Microbiology, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Roopa S Rao
- Department of Oral Pathology and Microbiology, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Barnali Majumdar
- Department of Oral Pathology and Microbiology, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
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15
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Razavi SM, Torabinia N, Mohajeri MR, Shahriyary S, Ghalegolab S, Nouri S. Expression of Bcl-2 and epithelial growth factor receptor proteins in keratocystic odontogenic tumor in comparison with dentigerous cyst and ameloblastoma. Dent Res J (Isfahan) 2015; 12:342-7. [PMID: 26288624 PMCID: PMC4533192 DOI: 10.4103/1735-3327.161451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Keratocystic odontogenic tumor (KCOT) is a developmental odontogenic cyst on which various investigations have been focused due to its biological activities, high tendency to recur and different growth mechanisms in comparison with other cystic lesions. Previous studies have shown different biological and proliferative activities for the lining epithelium of KCOT. The aim of this study was immunohistochemical evaluation of Bcl-2 and epidermal growth factor receptor (EGFR) expression in KCOT compared with dentigerous cyst and ameloblastoma. Materials and Methods: Formalin-fixed and paraffin-embedded tissue sections of 16 cases of KCOT, 16 cases of dentigerous cyst and 16 cases of ameloblastoma were immunohistochemically analyzed to determine Bcl-2 and EGFR proteins’ expression. Biotin-Stereotavidin method was used. It was observed by two oral pathologists separately, and the data were analyzed by Mann–Whitney and Kruskul–Wallis. P < 0.05 was considered as significant. Results: Regardless of staining intensity, all cases of ameloblastoma and KCOT except dentigerous cases were positively stained for Bcl-2. Expression of Bcl-2 was higher in the peripheral layer of ameloblastoma and basal layer of KCOT. Furthermore, all cases of ameloblastoma and dentigerous cysts except KCOT samples were positively stained for EGFR. Expression of EGFR was higher in the peripheral layer of ameloblastoma and basal layer of dentigerous cysts. Conclusion: According to the expression of — Bcl-2 in ameloblastoma and KCOT, and no expression of EGFR in KCOT, it can be concluded that the biological activity and growth mechanisms of KCOT are different compared with other cystic lesions. However, the aggressive potential of KCOT is not as severe as that of a neoplasm such as ameloblastoma.
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Affiliation(s)
- Seyed Mohammad Razavi
- Dental implant Research Center and Department of Oral Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nakisa Torabinia
- Dental Materials Research Center and Department of Oral Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Shahriyar Shahriyary
- Postgraduate student, Department of Operative Dentistry, Azad University of Khorosgan, Isfahan, Iran
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16
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Adenoid ameloblastoma: clinicopathologic description of five cases and systematic review of the current knowledge. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:368-77. [PMID: 26297394 DOI: 10.1016/j.oooo.2015.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 05/16/2015] [Accepted: 05/21/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the clinicopathologic and immunohistochemical features of five cases of adenoid ameloblastoma. STUDY DESIGN Clinicopathologic data were gathered from medical records and compared with those compiled from a systematic review. Slides were also immunohistochemically stained for Ki-67, p16, p53, and cytokeratins (7, 8, 14, 18, and 19). RESULTS There were 3 males (60%) and 2 (40%) females. The mean age was 44 ± 10 years. Of the five adenoid ameloblastomas, 4 (80%) occurred in the posterior maxilla. Patients typically complained of asymptomatic swelling. All patients received surgical resection as primary therapy; 1 (20%) patient also received adjuvant radiotherapy. Recurrence was diagnosed in all patients. Immunohistochemically, the tumors stained focally positive for CK7, 8, 14, and 18 and diffusely positive for CK-19, p16, and p53. The mean Ki-67-positive cells were 72.4 ± 24.9 positive cells per high-power field (range 53-111). CONCLUSIONS To our knowledge, this is the largest series of adenoid ameloblastoma reported in the literature. Our data suggest that this entity demonstrates aggressive behavior characterized by a high likelihood of recurrence.
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Hunter KD, Speight PM. The diagnostic usefulness of immunohistochemistry for odontogenic lesions. Head Neck Pathol 2014; 8:392-9. [PMID: 25409846 PMCID: PMC4245415 DOI: 10.1007/s12105-014-0582-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 10/30/2014] [Indexed: 10/24/2022]
Abstract
The diagnosis of odontogenic tumors can be challenging, largely due to their rarity and consequent difficulties in gaining experience in their assessment. In most cases, careful attention to morphology, in conjunction with clinical and radiological features will allow a diagnosis to be made. However, in some cases, immunohistochemical analysis of the tumor may be useful. In this review we will outline the immunohistochemical expression profile of normal developing odontogenic tissues and a range of odontogenic tumors. In many cases the immunohistochemical markers are neither specific nor sensitive enough to be of help in diagnosis, but in some cases such analysis may prove very useful. Thus we have outlined a limited number of circumstances where immunohistochemistry may be of use to the practicing diagnostic pathologist.
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Affiliation(s)
- Keith D. Hunter
- grid.11835.3e0000000419369262Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA UK
| | - Paul M. Speight
- grid.11835.3e0000000419369262Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA UK
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18
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Khosravi N, Razavi SM, Kowkabi M, Navabi AA. Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010). Dent Res J (Isfahan) 2013; 10:162-7. [PMID: 23946730 PMCID: PMC3731954 DOI: 10.4103/1735-3327.113325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Odontogenic cysts are relatively common lesions which can cause different complications. As demographic information is lacking in Iran and specially in Isfahan, the aim of this study was to determine the prevalence of odontogenic cysts according to age, gender and affected area among patients referring to the Oral Pathology Department of the Dental School of Isfahan University of Medical Sciences (Iran) over a 23-year period. Materials and Methods: A total of 7412 diagnosed lesions recorded in the Oral Pathology Department archives of Isfahan Dental School between 1988 and 2010 were reevaluated, then odontogenic cysts were separated through reviewing microscopic slides according to the 2005 World Health Organization classification and variables such as age, gender, the infected jaw, and its specific region were obtained by SPSS Version 16.0 from the recorded database. Results: 21.62% of the lesions were odontogenic cysts, of which 48.72% were inflammatory and 51.28% were developmental cysts. These cysts were more common in the mandible. The mean age of patients was 29.53 ± 16.1. Male to female ratio was 1.31:1. The four most frequent odontogenic cysts were radicular cysts (35.12%), dentigerous cysts (25.77%), odontogenic keratocysts (22.58%) and residual cysts (12.98%). Conclusion: Odontogenic cysts are fairly frequent jaw lesions (21.62%), of which radicular cyst was the most common cyst. The four most common lesions constituted a sum of 96.45% of the total. In general, the prevalence rates in our study are similar to the studies from other geographic parts of the world but with a lower incidence of inflammatory cysts, higher prevalence of dentigerous cysts and residual cysts and also mandibular predominance for residual cysts.
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Affiliation(s)
- Negin Khosravi
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Rahman F, Bhargava A, Tippu SR, Kalra M, Bhargava N, Kaur I, Srivastava S. Analysis of the immunoexpression of Ki-67 and Bcl-2 in the pericoronal tissues of impacted teeth, dentigerous cysts and gingiva using software image analysis. Dent Res J (Isfahan) 2013; 10:31-7. [PMID: 23878561 PMCID: PMC3714821 DOI: 10.4103/1735-3327.111764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Pericoronal tissue is the soft tissue located between the bony crypt and the impacted tooth, which is histologically composed of fibrous connective tissue and is usually lined by the reduced enamel epithelium. Increased epithelial cell proliferation in the pericoronal tissue is associated with pathological changes such as development of an odontogenic cyst or an epithelial odontogenic tumor. This study is an attempt to evaluate and compare the proliferative index in the epithelium surrounding the impacted third molar teeth, dentigerous cysts, and gingiva. MATERIALS AND METHODS A case control study on pericoronal tissues and dentigerous cysts was carried out using immunomarkers. Forty pericoronal tissues were obtained from asymptomatic impacted third molars with pericoronal radiolucency less than 2.5 mm. Samples of 20 dentigerous cysts and normal gingiva were also included. Routine hematoxylin and eosin and immunostaining for Ki-67, a cell proliferation marker and Bcl-2, an anti apoptotic protein were performed on sections of pericoronal tissues, dentigerous cysts, and gingival tissues. The percentage of Ki-67-positive cells and Bcl-2 positive areas was found using the DigiPro™ version 4.0 Image analysis software. Bcl-2 immunopositivity and Ki-67-Li were analyzed using the Chi-square test and paired t-test. P- values of less than .05 were considered to indicate statistical significance. RESULTS The immunohistochemical analysis revealed overexpression of Bcl-2 in the pericoronal tissues with squamous metaplasia, which was comparable to the dentigerous cyst. Ki-67 Li of the pericoronal tissue with squamous metaplasia was equal to the proliferative index of the dentigerous cyst. The expression of Ki-67 Li and inflammatory cells were highly significant (P < 0.0001). CONCLUSIONS The results of this study indicate that the pericoronal tissues of asymptomatic impacted third molars may be actively proliferating and normal pericoronal radiolucency cannot serve as an indicator for the differentiation potential.
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Affiliation(s)
- Farzan Rahman
- Department of Oral Pathology, Jaipur Dental College, Jaipur, Rajasthan, India
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20
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Razavi SM, Hasheminia D, Mehdizade M, Movahedian B, Keshani F. The relation of pericoronal third molar follicle dimension and bcl-2/ki-67 expression: An immunohistochemical study. Dent Res J (Isfahan) 2013; 9:S26-31. [PMID: 23814558 PMCID: PMC3692196 DOI: 10.4103/1735-3327.107931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Most common impacted teeth are the mandibular third molars and decision about extraction of them is usually controversial. The presence of pericoronal pathologic changes is an acceptable reason for removal of impacted teeth. Differences in the proliferation rate and apoptosis of odontogenic epithelial cells may influence on the formation of odontogenic epithelial lesions. Therefore, the aim of the present study is to evaluate the immunohistochemical expression of the bcl-2 apoptosis-inhibiting protein and the cell-cycle-related ki-67 antigen in pericoronal follicle of impacted third molars with ≥2.5 mm and <2.5 mm radiolucency. Materials and Methods: This was a cross-sectional study that 20 follicles with <2.5 mm radiolucency and 20 follicles with ≥2.5 mm radiolucency were selected by a professional radiologist in digital panoramic radiographs and then referred to a surgeon. Formalin fixed paraffin-embedded tissues were immunohistochemical analyzed for immunoreactivity of bcl-2 protein and ki-67 antigen. The data was analyzed using logistic regression, Spearman correlation coefficient and t-test and Mann-Whitney. P<0.05 was considered significant. Results: The findings showed correlation between size of the third molar's follicles and expression of bcl-2 protein (P < 0.001, r = 0.556) but there was no correlation between size of third molar's follicles and staining with ki-67 antigen (P = 0.546, r = 0.098). The follicles with radiolucency ≥2.5 mm showed increased immunoreactivity for bcl-2 protein. Conclusion: The results of study suggest that impacted third molars with radiolucency ≥2.5 mm may be associated with deregulation of cell death, indicated with increased expression of the anti- apoptotic protein bcl-2, while cell proliferation (ki-67) does not seem to play a significant role.
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Affiliation(s)
- Seyed Mohammad Razavi
- Torabinejad Dental Research Center and Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Lee SK, Kim YS. Current concepts and occurrence of epithelial odontogenic tumors: I. Ameloblastoma and adenomatoid odontogenic tumor. KOREAN JOURNAL OF PATHOLOGY 2013; 47:191-202. [PMID: 23837011 PMCID: PMC3701814 DOI: 10.4132/koreanjpathol.2013.47.3.191] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/25/2013] [Indexed: 01/10/2023]
Abstract
Ameloblastomas and adenomatoid odontogenic tumors (AOTs) are common epithelial tumors of odontogenic origin. Ameloblastomas are clinico-pathologically classified into solid/multicystic, unicystic, desmoplastic, and peripheral types, and also divided into follicular, plexiform, acanthomatous, granular types, etc., based on their histological features. Craniopharyngiomas, derived from the remnants of Rathke's pouch or a misplaced enamel organ, are also comparable to the odontogenic tumors. The malignant transformation of ameloblastomas results in the formation of ameloblastic carcinomas and malignant ameloblastomas depending on cytological dysplasia and metastasis, respectively. AOTs are classified into follicular, extrafollicular, and peripheral types. Ameloblastomas are common, have an aggressive behavior and recurrent course, and are rarely metastatic, while AOTs are hamartomatous benign lesions derived from the complex system of the dental lamina or its remnants. With advances in the elucidation of molecular signaling mechanisms in cells, the cytodifferentiation of epithelial tumor cells in ameloblastomas and AOTs can be identified using different biomarkers. Therefore, it is suggested that comprehensive pathological observation including molecular genetic information can provide a more reliable differential diagnosis for the propagation and prognosis of ameloblastomas and AOTs. This study aimed to review the current concepts of ameloblastomas and AOTs and to discuss their clinico-pathological features relevant to tumorigenesis and prognosis.
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Affiliation(s)
- Suk Keun Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Nafarzadeh S, Seyedmajidi M, Jafari S, Bijani A, Rostami-Sarokolaei A. A comparative study of PCNA and Ki-67 expression in dental follicle, dentigerous cyst, unicystic ameloblastoma and ameloblastoma. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2013; 2:27-33. [PMID: 24551787 PMCID: PMC3920517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/18/2013] [Indexed: 11/20/2022]
Abstract
Various cell proliferation markers are used as diagnostic and prognostic tools in oral lesions. Simultaneous evaluation of these markers can increase the precision of estimation of the proliferative status of different tissues. In this study we investigated the expression of PCNA and Ki-67 as markers of cell proliferation in 15 paraffin embedded samples of each dental follicle, dentigerous cyst, unicystic ameloblastoma and ameloblastoma belonging to a total of 30 male and 30 female paients using immunohistochemistry method. Expression levels based on the intensity and the percentage of stained cells was separately analyzed for each marker with chi-square test, the results of which were significant for the two markers (P<0.05). The correlation coefficient between the two markers was found to be 0.88. A significant difference in the expression of Ki-67 and PCNA was observed in the four types of studied lesions.
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Affiliation(s)
- Shima Nafarzadeh
- Dental material research center, Babol University of Medical Sciences, Babol, Iran.,Department of Oral and Maxillofacial Pathology, Dentistry school, Babol University of Medical Sciences, Babol, Iran.,Corresponding author: Department of Oral and Maxillofacial Pathology, Dentistry school, Babol University of Medical Sciences.
E-mail:
| | - Maryam Seyedmajidi
- Dental material research center, Babol University of Medical Sciences, Babol, Iran.,Department of Oral and Maxillofacial Pathology, Dentistry school, Babol University of Medical Sciences, Babol, Iran.
| | - Sina Jafari
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
| | - Ali Bijani
- Non-communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.
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