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.
Highlights
The keratocystic odontogenic tumor (KCOT) was defined by the World Health Organization (WHO) in 2005 as a benign, intraosseous tumor of odontogenic origin, with characteristic lining of parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior [1]
Some studies have shown that the local aggressiveness of odontogenic keratocyst (OKC) and its propensity for recurrence may be consistent with the expression of several markers of epithelial cell proliferation and apoptosis, including Ki-67 [8], bcl-2 [9], cyclin D1 [9], p53 [9], and proliferating cell nuclear antigen (PCNA) [9, 10]
We found that radiological evidence of multilocularity as well as radiological evidence of cortical perforation was significantly associated with recurrence of OKC (Table 1)
Summary
The keratocystic odontogenic tumor (KCOT) was defined by the World Health Organization (WHO) in 2005 as a benign, intraosseous tumor of odontogenic origin, with characteristic lining of parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior [1]. It was believed that this term better reflected the neoplastic nature of this lesion in comparison with the previous term of odontogenic keratocyst (OKC). Among reasons for this, the considerable variation in aggressiveness and propensity for recurrence of OKC is widely acknowledged [6, 8], and hitherto, no explicit clinical and radiological features have been determined to clearly demonstrate the potential for the aggressive growth and relapse of the lesion. Some studies have shown that the local aggressiveness of OKC and its propensity for recurrence may be consistent with the expression of several markers of epithelial cell proliferation and apoptosis, including Ki-67 [8], bcl-2 [9], cyclin D1 [9], p53 [9], and PCNA [9, 10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
