Investigation of clinicopathological parameters and expression of COX-2, bcl-2, PCNA, and p53 in primary and recurrent sporadic odontogenic keratocysts

Abstract

ObjectivesOdontogenic keratocyst (OKC) presents considerable variation in aggressiveness and propensity for recurrence, yet hitherto, no explicit clinicopathological features have been determined to clearly demonstrate the potential for relapse. This retrospective study aims to investigate the prognostic relevance of various clinicopathological features as well as immunoexpression of COX-2, bcl-2, PCNA, and p53 in sporadic OKC.Materials and methodsAmong 41 patients with OKC treated by enucleation, the frequency of recurrence for various clinicopathological features as well as immunoexpression for COX-2, bcl-2, PCNA, and p53 was evaluated.ResultsThe mean follow-up was 8.49 years, and recurrences were ascertained in 29.27% of cases. We found significant differences between recurrent and non-recurrent cysts in terms of multilocularity (P = 0.029), cortical perforation (P = 0.001), and lesion size (P < 0.001). Hazard risk for the recurrence was 3.362 (95% CI 1.066–10.598) for multilocular cysts, 7.801 (95% CI 2.1–28.985) for evidence of cortical perforation, and 1.004 (1.002–1.006) for 1 mm2 of lesion size on panoramic radiographs. We also found that immunoexpression of PCNA significantly correlates with the radiographic evidence of cortical perforation (P = 0.048) and that there is significant positive correlation between expression of COX-2 and bcl-2 (P = 0.001) as well as significant negative correlation between immunoexpression of COX-2 and age (P = 0.002). None of the other analyzed factors were associated with the recurrence.ConclusionsLarger size, multilocularity, and cortical perforation in sporadic OKC may be correlated with the relapse.Clinical relevanceImmunohistochemical analyses of COX-2, bcl-2, PCNA, and p53 lack prognostic utility in sporadic OKC.

Recurrence of odontogenic keratocysts and possible prognostic factors: Review of 455 patients

“…Multilocular lesions and daughter cyst formation were both associated with a higher recurrence rate, a finding consistent with previous studies (19,32). However, Naruse et al (12) and Kaczmarzyk et al (13) did not find any association between daughter cysts and recurrence rate. The discrepancy may be due to variations in the number of patients examined or the length of the follow-up period.…”

“…Although an association between sex and rOKC has previously been reported (29), the present study in addition to others, did not confirm this (6,30). The relationship between the site of involvement of OKC and recurrence is controversial (13,31). In our series, the sites of OKC were not statistically related to recurrence.…”

“…Clinicohistopathological studies and those focused on treatment methods related to recurrence have suggested that recurrence was due to operative treatment methods, rather than clinicopathological factors (5,9,10). On the other hand, various recent investigations have been performed to link the recurrence of OKC to clinicopathological factors such as large size, cortical perforation, tooth involvement in the lumen of the cyst, and daughter cysts (11-13). The findings appear to suggest that these prognostic factors may predict a high risk for recurrence.…”

Queratoquiste Odontogénico de amplia dimensión: reporte de caso

“…El Queratoquiste Odontogénico comprende el 13% de los quistes mandibulares (Karhade 2019), anteriormente la OMS lo definió como un tumor odontogénico queratoquístico (KCOT), por su alta recurrencia, agresividad, aparición de quistes satélites y mutaciones en el gen supresor tumoral PTCH1; y la asociación con el síndrome de Gorlin-Goltz, sin embargo, en el año 2017 la OMS lo clasificó nuevamente como quiste bajo el nombre de Queratoquiste Odontogénico (Kaczmarzyk et al, 2018;Kahraman, Gunhan, & Celasun, 2018;Polak, Jędrusik-Pawłowska, Drozdzowska, & Morawiec, 2019;Wright & Vered, 2017) El OKC puede crecer hasta un gran tamaño antes de manifestarse clínicamente, y tiene una alta recurrencia del 5% al 62% según estudios a diferencia de otros quistes de la mandíbula (Kshirsagar et al, 2019). Por lo que, el objetivo de este artículo es describir la importancia de esta lesión, su correcto diagnóstico y tratamiento oportuno.…”

Indicators of the cell cycle in the thyroid gland in rats when applying infusion of 0.9% solution of NaCl, lactoprotein with sorbitol or HAES-LX 5%

“…More than 60 imaging and evaluation markers have been proposed to determine apoptosis and cell proliferative activity. Proliferating cells that are at different stages of the mitotic cycle are immunohistochemically determined (Ki-67, PCNA, pl05, CDK-2, cdE) [8,18]. In particular, these markers identify not only cells that have entered the mitosis, but also cells that are in the process of preparation for division, which allows to evaluate their proliferative potential [4].…”