Expression of Ki67, CD31, CD68 and P53 in Peripheral and Central Giant Cell Granuloma of the Jaws

Abstract

Introduction: Giant cell granuloma is a relatively common lesion in oral cavity. Central giant cell granuloma usually treated with surgical excision with good prognosis. However in few cases, the lesion exhibits more aggressive behaviour, high recurrence rate and poor prognosis. It is difficult to identify these cases based on histological features so the need for diagnostic markers is of paramount importance to spare patients unwanted effects. Aim:To investigate expression of Ki67, CD31, CD68 and P53 proteins in peripheral and central (aggressive and non-aggressive) giant cell granuloma and whether their expression level can be used to differentiate between aggressive and non-aggressive types. Material and methods:A total of 33 cases; 15 cases of peripheral giant cell granuloma, 10 cases of nonaggressive central giant cell granuloma and 8 cases of aggressive central giant cell granuloma were tested for Ki64, CD31, CD68 and P53 expression using immunohistochemical staining.Results: Ki67 was expressed in all study cases with significantly higher levels in aggressive variant. CD31 expressed in all cases with significantly higher levels in peripheral giant cell granuloma. CD68 was expressed in all cases with no significant differences. P53 was only identified in central giant cell granuloma with significantly higher levels in aggressive type. Conclusion:Ki67 and P53 expression might be useful markers to identify aggressive central giant cell granuloma.

Expresión Inmunohistoquímica de Ki-67 en Lesión Central de Células Gigantes

“…La expresión promedio de Ki-67 en las CGM fue de 0,65 %, una expresión escasa que coincide con lo mencionado por otros autores, quienes no identificaron expresión de Ki-67 en CGM y sugieren que posiblemente las CME son la población responsable del crecimiento de esta lesión (O'Malley et al; de Souza et al, 1999;Souza et al, 2000;Kauzman et al;Kruse-Lösler et al, 2006;Al Sheddi et al, 2014;Kujan et al, 2015). Sin embargo, solo se encontró un estudio, en el que se identificó una fuerte expresión inmuno-histoquímica de Ki-67 en las CGM, exclusivamente en las LCCG consideradas agresivas, indicando que ambas CGM Y CME están activamente involucradas en la actividad proliferativa de estas lesiones (El-Attar et al, 2016). Posiblemente, estos resultados pueden deberse al método de evaluación semicuantitativo.…”

Evaluation of Development and Growth of Peripheral Giant Cell Granuloma Using Osteocalcin, Cd68, Cd34, and Ki-67 Markers

“…Peripheral giant cell granuloma (PGCG) is a hyperplastic lesion of the connective tissues that arises as a result of local irritation or trauma 7,24 . Diagnosis of PGCG can be easily reached through microscopic examination of H&E stained sections 4 .…”

“…The exact etiology of PGCG is unknown. Though, it is believed to originate from the periosteum of the alveolar ridge or the periodontal ligament as a result of local irritation or trauma [3][4][5] .…”

“…The cells which are responsible for the development and progression of these lesions; whether is it the multinucleated giant cells or the background mononuclear cells is still not clear 4 .…”

“…It is absent in the resting cells (G0). This fact makes it a superior marker for detecting the growth of the cells 4,18,19 .…”