Immunohistochemistry of Five Molecular Markers for Typing and Management of Ameloblastomas: A Retrospective Analysis of 40 Cases

Abstract

Purpose The aims of this study are to elucidate if molecular markers can be used to differentiate between the two main types of ameloblastoma (unicystic and solid/multicystic), and to determine whether a biologically 'less-aggressive' subtype exists. Methods A retrospective analysis of 33 solid/multicystic ameloblastomas and six unicystic ameloblastomas was completed using immunohistochemistry for five molecular markers: P16, P53, MMP-9, Survivin, and Ki-67. Tumors were graded as either negative or positive (mild, moderate, strong), and the results were related to both ameloblastoma subtypes and outcomes following treatment.Results Unicystic ameloblastomas were more likely to test strongly positive for P53 than solid/multicystic ameloblastomas (p \ 0.05), whereas the latter were more likely to be negative for Survivin (p \ 0.05). Solid/multicystic and Type 3 unicystic ameloblastomas that were positive for P16, but also negative for MMP-9 and Survivin, were less likely to recur than all other tumors (p \ 0.05). The proliferation index of an ameloblastic carcinoma (11 %) was shown to be higher than benign ameloblastomas (4.5 %).Conclusions Immunohistochemistry can be valuable in lesions where histological sub-typing of an ameloblastoma is unclear. A biologically 'less-aggressive' subtype may exist, and hence further research into this area is required.

Histomorphometric, Immunohistochemical, Ultrastructural Characterization of a Nano-Hydroxyapatite/Beta-Tricalcium Phosphate Composite and a Bone Xenograft in Sub-Critical Size Bone Defect in Rat Calvaria

“…There are currently 24 subtypes of metalloproteinases (MMPs) that have been described in humans, rodents, and amphibians [ 13 ]. MMP transcripts are commonly expressed at low levels, but these levels can increase rapidly when tissues undergo remodeling, such as with inflammation, and wound healing.…”

Soft Tissue Recurrence with a Mucocele of an Intraosseous Ameloblastoma

“…In ameloblastomas, as in many other malignant tumors, the expression or mutation of p53 has been examined [15]- [23]. Appel …”

“…It has also been studied in odontogenic tumors including ameloblastoma [15]- [23]. Appel et al reported that the immunohistochemical verification of more than 10% p53-positive ameloblastoma cells gives a prognostic indication for a tendency to recur [15].…”

Molecular biological findings of ameloblastoma

“…There are numerous reports on the role of MMPs in the invasion of ameloblastoma. Among them, there are many reports that MMP-2 and MMP-9 are expressed in ameloblastoma [ [42] , [43] , [44] , [45] , [46] , [47] , [48] ]. MMP-2 and MMP-9 are expressed in various cancers and are involved in angiogenesis and tumour growth, and many reports suggested a relationship with tumour aggressiveness and clinical course [ [49] , [50] , [51] ].…”