Immuno Histochemical Study of Osteosarcoma Using Ki-67 as a Labeling Index in Naturally Fluoridated Community

Abdullatef Nureddin

doi:10.19080/adoh.2016.01.555568

Abstract

Osteosarcoma is the most common primary malignant bone tumor which characterized microscopically by formation of osteoid or bone by the neoplastic cells (osteoblastic type) or production of fibrous tissue (fibroblastic type) and/or a cartilage (chondroblastic type). Ki-67 protein is present during all active phases of the cell cycle (G1, S, G2 and mitosis but is absent from resting cells (G0), makes it an excellent marker for determining the so called growth fraction of a given cell population. However, fluoride concentration in drinking water shows great variation between the costal-western region of Libya (mean fluoride concentration 1.38ppm) and Cairo-Egypt (0.4ppm). Therefore, the aim of this study is to evaluate and compare histopathologically the proliferative activity of Osteosarcomas in naturally fluoridated community (Libyan cases) and non-fluoridated community (Egyptian cases) as a retrospective case-control study using the labeling index Ki-67. 20 cases of Osteosarcoma from each country in a formalin-fixed embedded specimens and serial sections from the paraffin blocks for immuno histochemical examination were included in this study in which Peroxidase-antiperoxidase technique was performed. Assessment of Ki-67 proliferative activity was carried out using software image analysis and the area fraction was given by the percentage of immuno positive area to the total area of the microscope field. The result of this study showed that the mean value of area of fraction in Libyan cases was 5.33 and in Egyptian cases were 3.12. When comparing the area fraction of Ki67 immunopositivity of tumor cells in Lybian cases versus Egyptian cases, statistical analysis revealed a statistically significant difference (P value=0.023). It is concluded from this study that a high expression of Ki-67 of Osteosarcomas in fluoridated area compared to those of non-fluoridated area could explain the aggressive behavior of this tumor, in which fluoride ions may play a role as an underlying etiological factor.

Highlights

In conventional implant surgery, the elevation of a muco periosteal flap can facilitate implant placement by allowing the surgeon to visually assess bone quantity and morphology at the site
In cases with limited amount of bone, a flap elevation can help implant placement to reduce the risk of bone fenestrations or perforations over the past three decades there have been several alterations to this flap design in favor of flapless implant surgery which has gained popularity among surgeons
The Concept of flapless implant, where the implant is placed without reflecting a flap, has gained popularity among surgeons

Summary

Introduction

The elevation of a muco periosteal flap can facilitate implant placement by allowing the surgeon to visually assess bone quantity and morphology at the site. Nissaf Daouahi*, Dalenda Hadyaoui and Mounir Cherif In cases with limited amount of bone, a flap elevation can help implant placement to reduce the risk of bone fenestrations or perforations over the past three decades there have been several alterations to this flap design in favor of flapless implant surgery which has gained popularity among surgeons.

Results

Conclusion