Özcan Ayhan, Yavan İbrahim, Günhan Ömer
Department of Pathology, Gülhane Military Medical Academy, School of Medicine, ANKARA, TURKEY.
Turk Patoloji Derg. 2015;31(2):104-10. doi: 10.5146/tjpath.2014.01298.
Cystic ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and radicular cyst are the most commonly encountered cystic odontogenic lesions. The aim of this study was to investigate the expressions of survivin, E-cadherin, CD138, and CD38 in these lesions and their potential diagnostic usage.
A total of 20 cases, consisting 5 radicular cysts, 5 dentigerous cysts, 5 keratocystic odontogenic tumors and 5 cystic ameloblastomas were included in our series. For all cases, sections from the selected blocks were stained against the antibodies for survivin, E-cadherin, CD138, and CD38 on an automated device.
All cystic ameloblastomas and keratocystic odontogenic tumors showed diffuse and strong nuclear survivin expression. No specific survivin immunoreactivity was observed in the dentigerous and radicular cysts. E-cadherin expression was stronger in all dentigerous cysts and radicular cysts when compared to others. CD138 expression in stromal cells was prominent in cystic ameloblastomas, but gradually decreased in the other three lesions. All cases were negative for CD38.
In the present study, loss of E-cadherin expression in epithelial cells, strong CD138 expression in stromal cells and strong nuclear survivin expression both in epithelial and stromal cells in cystic ameloblastomas and keratocystic odontogenic tumors were the most remarkable findings. These findings are also reinforced by the studies suggesting their role in the aggressiveness and pathogenesis of these tumors.
囊性成釉细胞瘤、牙源性角化囊性瘤、含牙囊肿和根端囊肿是最常见的牙源性囊性病变。本研究旨在调查这些病变中生存素、E-钙黏蛋白、CD138和CD38的表达情况及其潜在的诊断用途。
本研究纳入20例病例，包括5例根端囊肿、5例含牙囊肿、5例牙源性角化囊性瘤和5例囊性成釉细胞瘤。对于所有病例，从所选组织块中切取的切片在自动设备上用抗生存素、E-钙黏蛋白、CD138和CD38的抗体进行染色。
所有囊性成釉细胞瘤和牙源性角化囊性瘤均显示生存素在细胞核中弥漫性强表达。在含牙囊肿和根端囊肿中未观察到特异性的生存素免疫反应性。与其他囊肿相比，所有含牙囊肿和根端囊肿中E-钙黏蛋白的表达更强。CD138在囊性成釉细胞瘤的基质细胞中表达突出，但在其他三种病变中逐渐降低。所有病例的CD38均为阴性。
在本研究中，囊性成釉细胞瘤和牙源性角化囊性瘤中上皮细胞E-钙黏蛋白表达缺失、基质细胞中CD138强表达以及上皮和基质细胞中生存素在细胞核中强表达是最显著的发现。这些发现也得到了一些研究的支持，这些研究表明它们在这些肿瘤的侵袭性和发病机制中起作用。
