背景:目前的证据表明,与牙源性角化囊肿(OKC)相关的卵圆形基底细胞癌综合征(NBCCS)表现出更积极的临床行为和更高的复发倾向。各种标志物在散发性和综合征性OKC中的预后效果尚不清楚,关于免疫组织化学在区分综合征和散发性OKC中的有用性的研究结果也是如此。
目的:这项回顾性研究旨在比较各种临床放射和组织病理学特征的预后相关性,以及COX-2,Bcl-2,增殖细胞核抗原(PCNA)的免疫表达,p53,Ki-67,骨保护素(OPG),核因子κB受体激活剂(RANK)和核因子κB受体激活剂配体(RANKL),以及零星和综合征性OKC之间的RANKL/OPG平衡,并测试它们在区分两种类型的OKC中的效用。
方法:我们比较了31个散发性OKC和12个综合征性OKC之间上述标志物的免疫表达,并测试了临床病理发现和免疫染色水平对复发的影响。
结果:我们发现NBCCS与OKC复发之间存在显著关联。PCNA有显著差异,散发性和综合征性OKC之间的p53和OPG免疫表达。我们还发现,复发性散发性OKC明显更大,并且与皮质穿孔有关。复发性零星OKC表现出COX-2上调,但我们未能证明其预后相关性。复发性综合征性OKC显示出明显较高的RANKL>OPG比率。
结论:NBCCS相关的OKC比它们的零星对应物更容易复发。散发性OKC中皮质穿孔的较大尺寸和放射学征象可能表明复发风险较高。COX-2在复发性散发性OKC中上调,而复发性综合征性OKCs表现出更高的RANKL和更低的OPG表达;然而,这些发现与预后无关.p53,PCNA和OPG的免疫表达可能有助于区分综合征和散发性OKC。
BACKGROUND: Current evidence suggests that nevoid basal cell carcinoma syndrome (NBCCS)-associated odontogenic keratocysts (OKCs) exhibit more aggressive clinical behavior and a higher tendency to relapse. The prognostic efficacy of various markers in sporadic and syndromic OKCs is unclear, and so are the results of studies on the usefulness of immunohistochemistry in distinguishing syndromic from sporadic OKCs.
OBJECTIVE: This retrospective
study aimed to compare the prognostic relevance of various clinicoradiological and histopathological features, as well as the immunoexpression of COX-2, Bcl-2, proliferating cell nuclear antigen (PCNA), p53, Ki-67, osteoprotegerin (OPG), receptor activator of nuclear factor κ B (RANK) and receptor activator of nuclear factor κ B ligand (RANKL), as well as RANKL/OPG balance between sporadic and syndromic OKCs, and to test their utility in distinguishing the 2 types of OKC.
METHODS: We compared the immunoexpression of the aforementioned markers between 31 sporadic and 12 syndromic OKCs, and tested clinicopathological findings and levels of immunostaining against recurrence.
RESULTS: We found a significant association between NBCCS and OKC recurrence. There were significant differences in PCNA, p53 and OPG immunoexpression between sporadic and syndromic OKCs. We also found that recurrent sporadic OKCs were significantly larger and markedly more often associated with cortical perforation. Recurrent sporadic OKCs exhibited COX-2 upregulation, but we failed to demonstrate its prognostic relevance. Recurrent syndromic OKCs showed a markedly higher RANKL > OPG ratio.
CONCLUSIONS: The NBCCS-associated OKCs are significantly more prone to recur than their sporadic counterparts. Larger size and radiological signs of cortical perforation in sporadic OKCs may indicate a higher risk of recurrence. The COX-2 is upregulated in recurrent sporadic OKCs, whereas recurrent syndromic OKCs exhibit higher RANKL and lower OPG expression; however, these findings have no prognostic relevance. The immunoexpression of p53, PCNA and OPG may help to distinguish syndromic from sporadic OKCs.