Analysis of histopathological aspects and bone destruction characteristics in acquired middle ear cholesteatoma of pediatric and adult patients

Aslıer, Mustafa; Erdağ, Taner Kemal; Sarıoğlu, Sülen; Günerı, Enis Alpin; İkiz, Ahmet Ömer; Uzun, Evren; Özer, Erdener

doi:10.1016/j.ijporl.2016.01.008

Cited by 11 publications

(12 citation statements)

References 19 publications

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“…This may indicate that both can be independent markers for the invasiveness of the lesion. In addition, we did not find significant correlation between the age of patients at the time of surgery and the grading score for bone erosion ( r =0.338, P =0.158) and this is matching with previous studies [ 6 , 7 , 24 ]. Mallet et al [ 7 ] did not find significant correlation between age and bone destruction in a larger cohort than our study (91 patients).…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, Juhasz et al [ 14 ] documented that “destructive” cholesteatomas with evidence of bone resorption had higher Ki-67 leveling than “nondestructive” ones that were completely free of bone resorption. In contrast, Aslier et al [ 24 ], comparing between pediatric and adult cholesteatomas, did not find any correlation between Ki-67 and bone erosion scores of cholesteatoma, by employing a new scoring system for bone erosion graded as “1” for incomplete ossicular destruction, and “2” referred to complete ossicular chain destruction but graded “2” only in case of destruction of the facial canal, tegmen and otic capsule as partial destruction of these structures could not be elicited. Finally, in an animal study of dogs, Banco et al [ 8 ] stated that the Ki-67 labeling index was higher in cholesteatoma than the meatal skin, but could not be used as a predictor for aggressiveness.…”

Section: Discussionmentioning

confidence: 96%

“…The lack of a standardized method to specify bone erosion and to distinguish invasive cholesteatomas from noninvasive ones made it a hard and confusing issue when interpreting and comparing the results [ 24 ]. We suggested an easy, strictly objective, broad and applicable scoring system by counting the number of eroded bones seen radiologically and confirmed intraoperatively, putting in mind complicated cases.…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the facial canal dehiscence, only cases with direct contact with cholesteatoma debris were scored [ 24 ]. Being simple, applicable and more adherent to the point, we see that our grading system was more advantageous than those prescribed in the previously mentioned reports.…”

Section: Discussionmentioning

confidence: 99%

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Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity

Hamed

Nakata

Shiogama

et al. 2017

Clin Exp Otorhinolaryngol

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Objectives Cholesteatoma is a nonneoplastic destructive lesion of the temporal bone with debated pathogenesis and bone resorptive mechanism. Both molecular and cellular events chiefly master its activity. Continued research is necessary to clarify factors related to its aggressiveness. We aimed to investigate the expression of Ki-67, cytokeratin 13 (CK13) and cytokeratin 17 (CK17) in acquired nonrecurrent human cholesteatoma and correlate them with its bone destructive capacity.Methods A prospective quantitative immunohistochemical study was carried out using fresh acquired cholesteatoma tissues (n=19), collected during cholesteatoma surgery. Deep meatal skin tissues from the same patients were used as control (n=8). Cholesteatoma patients were divided into 2 groups and compared (invasive and noninvasive) according to a grading score for bone resorption based upon clinical, radiologic and intraoperative findings. To our knowledge, the role of CK17 in cholesteatoma aggressiveness was first investigated in this paper.Results Both Ki-67 and CK17 were significantly overexpressed in cholesteatoma than control tissues (P<0.001 for both Ki-67 and CK17). In addition, Ki-67 and CK17 were significantly higher in the invasive group than noninvasive group of cholesteatoma (P=0.029, P=0.033, respectively). Furthermore, Ki-67 and CK17 showed a moderate positive correlation with bone erosion scores (r=0.547, P=0.015 and r=0.588, P=0.008, respectively). In terms of CK13, no significant difference was found between cholesteatoma and skin (P=0.766).Conclusion Both Ki-67 and CK17 were overexpressed in cholesteatoma tissue and positively correlated with bone resorption activity. The concept that Ki-67 can be a predictor for aggressiveness of cholesteatoma was supported. In addition, this is the first study demonstrating CK17 as a favoring marker in the aggressiveness of acquired cholesteatoma.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity

Hamed

Nakata

Shiogama

et al. 2017

Clin Exp Otorhinolaryngol

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“…Diaminobenzidine was applied for 10 min as a chromogen. The slides were counterstained with Mayer's hematoxylin, washed in water, dehydrated in increasing concentrations of ethanol, cleared in xylene and put in Canada balsam 13,14 . The number of immune cells that showed positive staining with the cell-specific antibodies was reported semiquantitatively.…”

Section: Methodsmentioning

confidence: 99%

The significance of the expression of cell proliferation and inflammation markers in the development of acquired middle ear cholesteatoma

et al. 2018

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Background/Aim. Permanent proliferation and periodical infection are the main clinical characteristics of acquired middle ear cholesteatoma. The aim of this study was to research immunohistochemical characteristics of the skin along with the cholesteatoma process in the nearby tissue. This research should influence further studying of etiology and development of acquired middle ear cholesteatoma. Methods. We investigated clinical, histological and immunohistochemical characteristics of cholesteatoma in 50 samples from operated patients with acquired middle ear cholesteatomas. We classified all samples according to their clinical characteristics of cholesteatoma such as bone destruction, presence of infection or cholesteatoma extension and histological characteristics of cholesteatoma such as keratinisation, inflammatory process and extracellular matrix proliferation. We used mouse monoclonal antibodies for proliferating cell nuclear antigen (MAbs for PCNA), Ki-67, COX-2, CD 4 and CD 8 lymphocytes to investigate the expression of those characteristics in the cholesteatoma and in the control skin tissue. Statistical analyses were performed using SPSS for Windows version 16.0 (SPSS, Chicago, IL, USA). We used the independent group t-test, Spearman?s correlation analysis and Mann-Whitney U test to analyze statistical analysis. Results. Expression of PCNA, Ki-67, COX-2 and CD 8 lymphocytes in more serious clinical picture of cholesteatoma was almost equal as in less serious clinical picture of cholesteatoma. There was statistically significantly higher concentration of inflammation marker CD 4 lymphocytes, both in the acquired cholesteatoma and in the skin of bony portion of the external auditory canal near fibrocartilaginous annulus in more serious clinical picture of cholesteatoma than in less serious clinical picture of cholesteatoma (p < 0.01). There was statistically significant difference of expression of PCNA, Ki- 67, COX-2, CD 4 and CD 8 lymphocytes between all cholesteatoma samples and the skin of bony portion of the external auditory canal (p < 0.05) and statistically significant difference of expression of those markers between the skin of bony portion of the external auditory canal and retroauricular skin (p < 0.05). Conclusion. Inflammation of the skin of bony portion of the external auditory canal is a milestone in pathogenesis of acquired middle ear cholesteatoma. Expression of CD 4 lymphocytes can be the prognostic factor for acquired cholesteatoma clinical picture development. We found so much diversity in biological behavior through very different levels of cholesteatoma development. Expression of Ki-67 in acquired middle ear cholesteatoma is a reliable and stable marker of proliferation for acquired middle ear cholesteatoma.

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Principles of Surgical Management of Cholesteatoma

Kaufman,

Santa Maria

2023

Textbook of Otitis Media

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Analysis of histopathological aspects and bone destruction characteristics in acquired middle ear cholesteatoma of pediatric and adult patients

Cited by 11 publications

References 19 publications

Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity

Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity

The significance of the expression of cell proliferation and inflammation markers in the development of acquired middle ear cholesteatoma

Principles of Surgical Management of Cholesteatoma

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