Analysis of the Neoplastic Nature of Odontogenic Keratocyst and its Comparison with other Selected Benign Odontogenic Tumours: An Immunohistochemical Analysis

Anand S Tegginamani, Shruthi DK, Karthik B


Odontogenic keratocyst (OKC) fi rst described by Philipsen in 1956 constitutes approximately 11% of all cysts of the jaws. Adenomatoid odontogenic tumour (AOT) is an uncommon, benign epithelial lesion of odontogenic origin. The aim of this study was to analyse the expression of Bcl-2 in OKC and its comparison with other selected benign odontogenic tumours (OTs). Ten formalin fi xed paraffi n embedded blocks of OKCs, fi ve each of AOT and unicystic ameloblastoma Bcl-2 protein is characterized by its ability to inhibit apoptosis. OKC were characterized by higher expression of Bcl-2 in basal cell epithelium. AOT and unicystic ameloblastoma differed from OKC in a wide spectrum of apoptosis and/or cell cycle-related protein expressions, higher proliferation in the basal cell layer, and vice versa, lower proliferation in the suprabasal cell layer. The solitary OKC seems to be less biologically aggressive and should be classifi ed as a cyst rather than a tumour, means that at least few of OKCs manifests as ordinary cysts. Some of the present study fi ndings could support the theory that OKCs are with high proliferative, probably that these lesions are developmental cysts with some neoplastic properties because of the high intrinsic growth potential. WHO recommends the term KCOT as it better refl ects the neoplastic nature of the lesion; however, this reclassifi cation has not yet been universally accepted.

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K Bal, X Li, H Wang, Y Liu, G Zheng, Z Yang1, MLi, K Shimizutani and T Koseki. Correlation between imaging features and epithelial cell proliferation in keratocystic odontogenic tumours Dentomaxillofacial Radiology. (2010). 39: 368–74.

Madras J, Lapointe H. Keratocystic odontogenic tumour: reclassifi cation of the odontogenic keratocyst from cyst to tumour. J Can Dent Assoc. (2008). 74:165–165h.

Shear M. The aggressive nature of the odontogenic keratocyst: is it a benign cystic neoplasm? Part 2.proliferation and genetic studies. Oral Oncol. (2002). Jun; 38(4): 323–31.

Qing Dong, Shuang Pan, Li-Sha Sun; Tie-Jun Li. Orthokeratinized Odontogenic Cyst: a clinicopathologic study of 61 cases. Arch Pathol Lab Med. (2010). 134: 271–5.

Robinson L, Martinez MG, Unicystic ameloblastoma: a prognostically distinct entity.

Cancer. (1977). 40:2278–85.

Pindborg JJ, Kramer IRH. WHO histological typing of odontogenic tumors, jaw cysts and allied lesions. (1971). Geneva.

Rui Amaral Mendes, João FC Carvalho, Isaac van derWaal. Biological pathways involved in the aggressive behavior of the keratocystic odontogenic tumor and possible implications for molecular oriented treatment—an overview. Oral Oncology. (2010). 46: 19–24.

Hockenbery DM, Zutter M. Hickey W, Nahm M, Korsmeyer SJ. Bcl-2 protein is topographically restricted in tissues characterized by apoptotic cell death. Proc Natl Acad Sci. (1991). 88(16): 6961–5.

DS MacDonald-Jankowski Keratocystic odontogenic tumour: systematic review dentomaxillofacial radiology. (2011). 40: 1-23.

Elizabeth A. Grasmuck, Brenda L, Nelson. Keratocystic Odontogenic Tumor Head and Neck Pathol. (2010). 4:94-6.

Gaitan-Cepeda L A, Quezada-Rivera D, Tenorio-Rocha F, Leyva-Huerta ER. Reclassifi cation of odontogenic keratocyst as tumour. impact on the odontogenic tumours prevalence. Oral diseases. (2010). 16: 185–7.

Jing W, Xuan M, Lin Y et al. Odontogenic tumours: a retrospective study of 1642 cases in a Chinese population. Int J Oral Maxillofac Surg. (2007). 36: 20–25.

Brunelle JK, Letai A. Control of mitochondrial apoptosis by the Bcl-2 family. J Cell Sci. (2009). 122:437–41.

Leber B, Lin J, Andrews DW: Embedded together: the life and death consequences of interaction of the Bcl-2 family with membranes. Apoptosis. (2007). 12: 897–911.

Fletcher JI, Meusburger S, Hawkins CJ, Riglar DT, Lee EF, Fairlie WD, Huang DC, Adams JM: Apoptosis is triggered when prosurvival Bcl-2 proteins cannot restrain Bax. Proc Natl Acad Sci USA. (2008). 105: 18081–7.

Vered M, Peleg O, Taicher S, Buchner A. The immunoprofi le of odontogenic keratocyst (keratocystic odontogenic tumor) that includes expression of PTCH, SMO, GLI-1 and bcl-2 is similar to ameloblastoma but different from odontogenic cysts. J Oral Pathol Med (2009). 38: 597–604.

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