Yoon Hye-Jung, Jo Byoung-Chan, Shin Wui-Jung, Cho Young-Ah, Lee Jae-Il, Hong Sam-Pyo, Hong Seong-Doo
Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Dec;112(6):767-76. doi: 10.1016/j.tripleo.2011.06.036. Epub 2011 Oct 19.
Ameloblastic carcinoma combines the histologic features of ameloblastoma with cytologic atypia, regardless of whether it has metastasized. Because of its rarity, there are few immunoprofile studies of ameloblastic carcinoma and few comparative studies of ameloblastic carcinoma and ameloblastoma. In this study, we compared the expression levels of cytokeratins (CKs), matrix metalloproteinases (MMPs), and Ki-67 between ameloblastoma and ameloblastic carcinoma, and assessed the usefulness of these markers for differentiating the tumors.
We assessed CK7, CK14, CK18, CK19, MMP-2, MMP-9, and Ki-67 expression by immunohistochemistry in 10 cases of ameloblastoma and 7 cases of ameloblastic carcinoma and then compared expression patterns between the 2 groups.
Immunostaining for CK14 and CK19 was diffuse and strongly positive in both tumor types, but staining for CK7 was focally positive in only 1 case of ameloblastoma and absent in all cases of ameloblastic carcinoma. However, there was a significant difference in CK18 expression between the 2 tumors (P = .000). Whereas 80% of ameloblastomas showed negative reactivity for CK18, most cases of ameloblastic carcinomas showed a moderate to strong intensity of immunostaining for CK18. Regarding the expression of MMPs, there were significant differences in parenchymal MMP-2 and stromal MMP-9 expression between the 2 tumors. Compared to ameloblastoma, ameloblastic carcinoma showed significantly strong expression of MMP-2 in parenchymal cells (P = .001) and MMP-9 in stromal cells (P = .013). However, there were no differences in MMP-2 expression of stromal cells and MMP-9 expression of parenchymal cells between ameloblastoma and ameloblastic carcinoma. The mean Ki-67 labeling index (LI) of ameloblastic carcinomas was 17.21%, which was significantly higher than that of ameloblastomas (3.57%; P = .002).
The significant expression of CK18, parenchymal MMP-2, stromal MMP-9, and Ki-67 could provide useful markers for differentiating ameloblastic carcinoma from ameloblastoma.
成釉细胞癌兼具成釉细胞瘤的组织学特征和细胞异型性，无论其是否发生转移。由于其罕见性，关于成釉细胞癌的免疫表型研究较少，成釉细胞癌与成釉细胞瘤的比较研究也较少。在本研究中，我们比较了成釉细胞瘤和成釉细胞癌中细胞角蛋白（CKs）、基质金属蛋白酶（MMPs）和Ki-67的表达水平，并评估了这些标志物在鉴别肿瘤中的作用。
我们通过免疫组织化学评估了10例成釉细胞瘤和7例成釉细胞癌中CK7、CK14、CK18、CK19、MMP-2、MMP-9和Ki-67的表达，然后比较了两组之间的表达模式。
两种肿瘤类型中CK14和CK19的免疫染色均呈弥漫性强阳性，但CK7染色仅在1例成釉细胞瘤中呈局灶性阳性，在所有成釉细胞癌病例中均未出现。然而，两种肿瘤之间CK18表达存在显著差异（P = .000）。80%的成釉细胞瘤对CK18呈阴性反应，而成釉细胞癌的大多数病例对CK18呈中度至强免疫染色强度。关于MMPs的表达，两种肿瘤之间实质MMP-2和基质MMP-9表达存在显著差异。与成釉细胞瘤相比，成釉细胞癌在实质细胞中MMP-2表达显著增强（P = .001），在基质细胞中MMP-9表达显著增强（P = .013）。然而，成釉细胞瘤和成釉细胞癌之间基质细胞MMP-2表达和实质细胞MMP-9表达没有差异。成釉细胞癌的平均Ki-67标记指数（LI）为17.21%，显著高于成釉细胞瘤（3.57%；P = .002）。
CK18、实质MMP-2、基质MMP-9和Ki-67的显著表达可为成釉细胞癌与成釉细胞瘤的鉴别提供有用的标志物。
