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Abstract：
The aim of this study was to identify all clinical, radiological, histopathological, and immunohistochemical features associated with recurrence of odontogenic keratocysts (OKCs) in the literature and formulate a recurrence risk stratification based on these findings. A search was performed in PubMed/Medline, Scopus, Web of Science, Google Scholar and Cochrane databases for clinical and laboratory studies reporting on clinico-pathological features that led to OKC recurrences for the period 2000 to 2020. Twenty-three studies were identified and analyzed qualitatively. A total of 2064 OKCs were included of which 439 OKCs were recurrent with a mean follow-up period of 46.7 months. Significantly associated parameters with OKC recurrence included age (variable age categories), large (>4 cm), multilocular lesions with cortical perforation, association with dentition, presence of daughter cysts, and epithelial budding. Immunohistochemical markers including high Ki67 index and AgNOR count were also implicated. A recurrence risk stratification was formulated based on these findings. Although the level of evidence from the included studies was low, there was considerable evidence that the clinico-pathological parameters identified were linked with higher OKC recurrence. The surgeon, radiologist, and pathologist should aim to identify these features when making a diagnosis so as to determine the appropriate management regime and prevent recurrences.
摘要：
这项研究的目的是确定所有临床，放射学,组织病理学,和与文献中牙源性角化囊肿（OKCs）复发相关的免疫组织化学特征，并根据这些发现制定复发风险分层。在PubMed/Medline中进行了搜索，Scopus,WebofScience,GoogleScholar和Cochrane数据库用于临床和实验室研究，报告导致2000年至2020年OKC复发的临床病理特征。对23项研究进行了定性和分析。共包括2064个OKC，其中439个OKC复发，平均随访期为46.7个月。与OKC复发显著相关的参数包括年龄（可变年龄类别），大（>4厘米），多房性病变伴皮质穿孔，与牙列有关，女儿囊肿的存在，上皮出芽。还涉及免疫组织化学标志物，包括高Ki67指数和AgNOR计数。根据这些发现制定了复发风险分层。尽管纳入研究的证据水平很低，有大量证据表明,所确定的临床病理参数与较高的OKC复发相关.外科医生,放射科医生,病理学家在做出诊断时应该致力于识别这些特征，以便确定适当的管理方案并防止复发。
