[Expression of p-p38MARK, uPA and Ki-67 in epithelial odontogenic tumour]

OBJECTIVE

to examine the expression of phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK), urokinase plasminogen activator (uPA) and Ki-67.

METHODS

the specimens of ameloblastoma (AB), keratocystic odontogenic tumour (KCOT), calcifying epithelial odontogenic tumor (CEOT), adenomatoid odontogenic tumour (AOT), calcifying cystic odontogenic tumour (CCOT) and 5 tooth germs were examined immunohistochemically for the expression of p-p38MAPK, uPA and Ki-67.

RESULTS

p-p38MAPK was detected both in the cytoplasm and the nucleus of the epithelial odontogenic tumour cells and uPA in the cytoplasm of the epithelial odontogenic tumour cells. Among the 65 cases, there were 17 (26%), 51 (78%) and 62 cases (95%) of positive expression of p-p38MAPK, uPA and Ki-67 protein respectively. Furthermore, there was a statistically significant difference in the expression of p-p38MAPK, uPA and Ki-67 between epithelial odontogenic tumor group and tooth germ group (P < 0.05). There were significant correlations among the expression of p-p38MAPK, uPA and Ki-67 (P < 0.05).

CONCLUSIONS

the p38MAPK-signaling pathway could promote tumour growth and invasion in epithelial odontogenic tumour by up-regulating uPA protein expression and may play a role in oncogenesis, invasion and proliferation of epithelial odontogenic tumour.

[Expression of HOX C13 in odontogenic tumors]

PURPOSE

To study the expression of HOXC13 mRNA in odontogenic tumors.

METHODS

HOXC13 mRNA was detected in 47 cases of ameloblastoma (AB), 3 cases of calcifying cystic odontogenic tumor (CCOT), 3 cases of ameloblastic fibroma (AF), 10 cases of keratocystic odontogenic tumor (KCOT) and 2 cases of calcifying epithelial odontogenic tumor (CEOT) by in situ hybridization, and 7 cases of normal oral mucosa were selected as control. SPSS10.0 software package was used for chi(2) test.

RESULTS

HOXC13 mRNA was positively expressed in all odontogenic epithelium except AF. The positive ratios were 97.9% in AB, 100% in CCOT, 100% in CEOT, 70.0% in KCOT epithelium and 42.9% in the normal oral mucosa. There was significant difference among AB, KCOT and normal mucosa (chi(2)=21.665, P<0.001).

CONCLUSIONS

The genesis and development of odontogenic tumors are related to the high expression of HOXC13. The expression of HOXC13 mRNA in the odontogenic lesions has heterogeneity.

Calcifying epithelial odontogenic tumor: an immunohistochemical case study

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor. A case of CEOT in a 25-year-old female is presented here. Histologically, the case showed sheets of polyhedral epithelial cells with deep eosinophilic cytoplasm and prominent nuclei. Nuclear pleomorphism and hyperchromatism were evident. Globules of amyloid-like material among the tumor cells were prominent. Also found was a small area demonstrating a cribriform pattern. Immunohistochemical studies with antibodies against basement membrane proteins (laminins 1 and 5, collagen type IV and fibronectin), pan-cytokeratins AE1/AE3, vimentin, S-100 protein and CD 1a were performed. Tumor cells expressed laminins 1 and 5, fibronectin, cytokeratins and vimentin. The amyloid-like material was not reactive to all antibodies examined. A number of dendritic cells among sheets of tumor cells were revealed with strong staining for S-100 protein and CD 1a. These dendritic cells are likely to be Langerhans cells. Hence, immunohistochemistry is a useful method to study the variant of CEOT.

[Expression of nuclear factor-kappaB, Ki-67 and matrix metalloproteinase-9 in calcifying odontogenic cyst]

OBJECTIVE

To evaluate the expression of nuclear factor-kappaB (NF-kappaB), Ki-67 and matrix metalloproteinase-9 (MMP-9) in calcifying odontogenic cyst (COC), in order to investigate the proliferation and invasion of COC.

METHODS

Twenty-six cases of COC were classified into calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) based on the WHO classification of odontogenic tumors in 2005. The specimens of COC and 10 classic ameloblastoma (AB) were examined immunohistochemically to determine the expression of NF-kappaB p65, Ki-67 and MMP-9.

RESULTS

NF-kappaB was mainly detected in the cytoplasm of most tumor cells, but was only detected in the nucleus of few tumor cells (rate of nuclear staining < 1%). The expression of Ki-67 was significantly higher in GCOC than in CCOT (P < 0.001), DGCT (P < 0.05) and AB (P < 0.005). MMP-9 was detected both in tumor cells and stromal cells. GCOC showed significantly higher percentage of MMP-9 positive cases in stromal cells than CCOT, DGCT and AB (P < 0.05).

CONCLUSIONS

NF-kappaB may minimally affect the progression and invasion of COC. GCOC shows significantly higher proliferative activity and aggressiveness than CCOT and DGCT. MMP-9 in stroma may play a key role in the invasion of GCOC.

Expression of hard alpha-keratins in pilomatrixoma, craniopharyngioma, and calcifying odontogenic cyst

To examine the properties of shadow and ghost cells, 3 kinds of antibodies were raised against human hair proteins and their immunoreactivity was examined in tumors expressing those cells: pilomatrixoma, 14 cases; craniopharyngioma, 17 cases; and calcifying odontogenic cyst (COC), 14 cases. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analyses demonstrated that 2 polyclonal antibodies, PA-HP1 and PA-HP 2, reacted strongly with type I acidic and type II neutral/basic hard alpha-keratins. The other monoclonal antibody, MA-HP1, reacted with type II neutral/basic hard alpha-keratins. Immunohistochemical examination revealed that all 3 antibodies reacted only with the hair shaft in sections of normal skin and dermoid cyst. In all pilomatrixoma cases, 3 antibodies reacted with the cytoplasm of transitional and shadow cells but not with that of basophilic cells. Positive reactions were found only in shadow cells of all 13 adamantinomatous craniopharyngiomas. In all COCs, the antibodies reacted only with ghost cells, not with other epithelial components. Immunoreactivity for phosphothreonine, detected in hard alpha-keratins, also was found in transitional, shadow, and ghost cells. The appearance of shadow or ghost cells might represent differentiation into hair in these 3 kinds of tumors.

Histopathological and immunohistochemical analysis of calcifying odontogenic cysts

METHOD AND RESULTS

Calcifying odontogenic cysts (COCs) were examined histopathologically and immunohistochemically to characterize the histological and cytological properties of these lesions. Histopathologically, COCs showed thin or thick lining epithelium with ghost cells. COCs were classified according to proliferative type or nonproliferative type lining epithelium, the presence or absence of ameloblastomatous appearance, and the presence or absence of odontoma in the cyst walls. Immunohistochemically, amelogenin protein was expressed chiefly in ghost cells, whereas cytokeratin 19 (CK19) and bcl-2 proteins were expressed chiefly in lining epithelial cells. The proportion of cases positive for bcl-2 protein was slightly higher in COCs with odontoma than in those without odontoma. Lining epithelial cells sporadically showed positive reactions for Ki-67 antigen. Mean Ki-67 labeling index was slightly greater in COCs with proliferative type lining epithelium, COCs with ameloblastomatous appearance of the cyst walls, and COCs with odontoma of the cyst walls than in COCs without these histological features. Our results suggest that ghost cells or lining epithelial cells show ameloblastic cytodifferentiation or odontogenic epithelial characteristics, that bcl-2 protein is associated with survival of lining epithelial cells in COCs, and that high proliferation potential is associated with ameloblastomatous proliferation or combined odontoma. COCs exhibited various histological features with several transitional forms, and immunohistochemical examinations revealed little or no difference in cytodifferentiation and cellular activity among COCs.

CONCLUSION

We conclude that COCs with various histological features have neoplastic potential and may not be separate entities within the same histological spectrum.

Immunohistochemical demonstration of an enamel sheath protein, sheathlin, in odontogenic tumors

Enamel proteins can be useful markers for assessment of the functional differentiation of neoplastic epithelium and the nature of extracellular matrices in odontogenic tumors. In the present study, we examined immunohistochemical localization of sheathlin, a recently cloned enamel sheath protein, in various odontogenic tumors to evaluate functional differentiation of tumor cells and the nature of hyalinous or calcified matrices in odontogenic neoplasms. Distinct immunolocalization of sheathlin was observed in the immature enamel of the tooth germ at the late bell stage. Secretory ameloblasts facing the enamel matrix also showed positive staining in their cytoplasm. Definite localization of sheathlin was demonstrated in the enamel matrix in odontogenic tumors with inductive dental hard tissue formation such as ameloblastic fibroodontomas and odontomas. Immunoexpression of sheathlin was, furthermore, demonstrated in eosinophilic droplets in solid nests of adenomatoid odontogenic tumor (AOT) and ghost cells in the epithelial lining of calcifying odontogenic cyst (COC). In AOT, cells facing the eosinophilic droplets also expressed the protein in their cytoplasm. There was neither intracellular staining for sheathlin in the tumor cells nor extracellular staining in the matrix of ameloblastomas and calcifying epithelial odontogenic tumors. Dentin, dysplastic dentin-like hyaline material and cementum in the tumors examined were negative for sheathlin. These results show that immunodetection of sheathlin is a useful marker for functional differentiation of secretory ameloblasts and enamel matrix, which is often hard to differentiate from other hard tissues in odontogenic tumors. Our findings from the view point of sheathlin expression support that the tumor cells of ameloblastomas do not attain full differentiation into functional ameloblasts. It is very interesting that epithelial cells in odontogenic tumors can differentiate into functional ameloblasts without induction by odontogenic mesenchyme, as shown by immunoexpression of sheathlin in eosinophilic droplets within solid epithelial sheets in AOT and ghost cells in the epithelial lining of COC where inductive participation of mesenchymal cells was most unlikely.

Ghost cells in calcifying odontogenic cyst express enamel-related proteins

The so-called ghost cell is a unique cell type occurring in a variety of odontogenic and non-odontogenic lesions. However, the true nature of ghost cells has not been determined. In the present study, we examined the immunoreactivity of ghost cells in calcifying odontogenic cysts and dermal calcifying epitheliomas, with antibodies against amelogenin, enamelin, sheath protein (sheathlin) and enamelysin, in an attempt to clarify the nature of this unique cell. The cytoplasm of ghost cells in calcifying odontogenic cysts demonstrated distinct immunolocalization of the enamel-related proteins, while similar in the calcifying epitheliomas of the skin showed a negative reaction. The results indicate that the ghost cells in calcifying odontogenic cysts, as opposed to ghost cells in dermal calcifying epitheliomas, contain enamel-related proteins in their cytoplasm accumulated during the process of pathological transformation.

Odontogenic ghost cell carcinoma: report of four new cases and review of the literature

Only 12 odontogenic ghost cell carcinomas (OGCC) have been reported in the English language literature to date. This article reports four additional cases of this rare odontogenic tumour and examines them in relation to those previously described. Judging from the number of published cases, the OGCC is more prevalent in Asians than other racial groups, occurs more often in the maxilla than the mandible, and is slightly more common in males than females. Histologically, elements of a benign calcifying odontogenic cyst (COC) can be identified in all the malignant variants, either separated or admixed with the malignant epithelial component. The latter can consist of either small basaloid cells or large epithelial cells. Despite the differing histological presentations, the biological behavior of the tumour is unpredictable, with some cases characterized by relatively indolent growth and others by a locally aggressive and potentially fatal course. The tumour apparently arises most often from malignant transformation of a preexisting benign COC, although it may also develop from other odontogenic tumours.

[Expression of P27 protein in odontogenic tumors]

The expression of P27 protein was investigated in 40 cases of odontogenic tumors by immunohistochemical S-P assay. The results showed that P27 expression varied in different types of odontogenic tumors. Positive signals were present in 17/20 (85.0%) of the malignant odontogenic tumors, but in 6/20 (30.3%) of the benign ones (P < 0.005). It was suggested that P27 protein had certain practical value in the differentiation diagnosis of odontogenic tumors.

Neoplastic odontogenic epithelial cells express bone sialoprotein

Bone sialoprotein (BSP) is synthesized and secreted by bone-, dentine- and cementum-forming cells and has been implicated in de novo bone formation and mineralization. In this study, we used histological sections of odontogenic neoplasms and performed immunohistochemical and in situ hybridization analyses. In ameloblastoma, BSP mRNA signals were seen in the neoplastic epithelial cells forming nests, strips and islands. BSP deposition was also seen in the stellate reticulum of the tumour masses revealed by immunohistochemistry using human BSP antibodies. In calcifying epithelial odontogenic tumour, the calcified masses demonstrated positive immunoreactivity to the human BSP antibodies, and the hybridization signals for BSP were located in the cells near the calcified particles. In the calcifying odontogenic cyst, strong BSP signals were seen in cells surrounding the characteristic nests of ghost cells, which often calcify subsequently. BSP protein was also found in these cells by immunohistochemistry. The active expression of BSP in the epithelial elements of the odontogenic tumours of adult patients suggests the activation of this matrix protein gene in the neoplastic process, and that BSP may play an important role in tumour formation and differentiation with respect to pathological calcification.

Calcifying odontogenic cyst associated with compound odontoma: a study on undemineralized material

In a minority of cases of calcifying odontogenic cyst (COC) it is possible to observe the formation of dental hard tissues in the cyst wall. The use of undemineralized sections has allowed an evaluation of the mineralized tissues normally lost with the use of demineralizing agents. All the dental hard tissues presented a high degree of morpho- and histodifferentiation. The histochemical staining for calcium salts (von Kossa) showed the presence of areas of low mineralization in the portion of the lesion, where the tissue maturation was not complete. In conclusion the appearance of the dental hard tissues in this case of compound odontoma arising in the cyst wall of a COC is similar to that already described in compound odontoma not associated with COC.