Can p63 serve as a biomarker for giant cell tumor of bone? A Moroccan experience

Abstract

BackgroundMultinucleated giant cell-containing tumors and pseudotumors of bone represent a heterogeneous group of benign and malignant lesions. Differential diagnosis can be challenging, particularly in instances of limited sampling. The purpose of this study was to evaluate the contribution of the P63 in the positive and differential diagnosis of giant cell tumor of bone.MethodsThis study includes 48 giant cell-containing tumors and pseudotumors of bone. P63 expression was evaluated by immunohistochemistry. Data analysis was performed using Epi-info software and SPSS software package (version 17).ResultsImmunohistochemical analysis showed a P63 nuclear expression in all giant cell tumors of bone, in 50% of osteoid osteomas, 40% of aneurysmal bone cysts, 37.5% of osteoblastomas, 33.3% of chondromyxoide fibromas, 25% of non ossifiant fibromas and 8.3% of osteosarcomas. Only one case of chondroblastoma was included in this series and expressed p63. No P63 immunoreactivity was detected in any of the cases of central giant cell granulomas or langerhans cells histiocytosis. The sensitivity and negative predictive value (NPV) of P63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 100%. The specificity and positive predictive value (PPV) were 74.42% and 59.26% respectively.ConclusionsThis study found not only that GCTOB expresses the P63 but it also shows that this protein may serve as a biomarker for the differential diagnosis between two morphologically similar lesions particularly in instances of limited sampling. Indeed, P63 expression seems to differentiate between giant cell tumor of bone and central giant cell granuloma since the latter does not express P63. Other benign and malignant giant cell-containing lesions express P63, decreasing its specificity as a diagnostic marker, but a strong staining was seen, except a case of chondroblastoma, only in giant cell tumor of bone. Clinical and radiological confrontation remains essential for an accurate diagnosis.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1838562590777252.

A diagnosis of giant cell-rich tumour of bone is supported by p63 immunohistochemistry, when more than 50 % of cells is stained

“…Recently, Yanagisawa et al reported that the highest scores of p63 expression are found in tumours that recur [9]. Contrary to earlier studies on the diagnostic value of p63 expression in giant-cell rich lesions [4,5], we and others [10,11] found wider expression also in chondroblastoma and ABC, which are the main differential diagnoses. Like De la Roza et al [10], we found p63 expression in some RG but with a low number of stained cells (mean=4.5 %).…”

Potential role of TP63 in apical periodontitis development

“…TP63 expression was observed mainly in the epithelial cells lining of radicular cysts, but also in the nuclei of a few mononuclear cells in the granulation tissues of radicular cyst, apical abscess and periapical granulomas. Interestingly, while TP63 expression is most commonly associated with epithelial cells, studies have shown that it may be expressed in stromal cells of giant cell tumours of the bone (Dickson et al 2008, Lee et al 2008, de la Roza 2011, Hammas et al 2012, Lau et al 2013, Shooshtarizadeh et al 2016, as well as in neoplastic lymphocytes in patients with non-Hodgkin's lymphoma (Hedvat et al 2005, Park & Oh 2005, Deel et al 2016. Additionally, although TP63 expression is commonly detected in the cell nuclei, studies have found cytoplasmic TP63 expression in lung, prostate and skin cancers (Narahashi et al 2006, Dhillon et al 2009, Matin et al 2013.…”

Central giant cell lesion of the mandible in a 2-year old girl

“…The multinucleated giant cells and mononuclear cells were positive for CD68, 10 RANK, 11 and cathepsin K 12 by immunohistochemistry, but were negative for p63. 13 14 15 The nuclear shapes of the mononuclear cells were not similar to those of the multinucleated giant cells. The cellular and nuclear atypia of these cells was mild.…”