Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria.
Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Oral Dis. 2018 Apr;24(3):307-316. doi: 10.1111/odi.12646. Epub 2017 Mar 9.
Ameloblastoma is a benign odontogenic tumor of epithelial origin. It is locally aggressive with unlimited growth capacity and has a high potential for malignant transformation as well as metastasis. Ameloblastoma has no established preventive measures although majority of patients are between ages 30 and 60 years. Molecular and genetic factors that promote oncogenic transformation of odontogenic epithelium to ameloblastoma are strongly linked to dysregulation of multiple genes associated with mitogen-activated protein kinase, sonic hedgehog, and WNT/β-catenin signaling pathways. Treatment of ameloblastoma is focused on surgical resection with a wide margin of normal tissue because of its high propensity for locoregional invasion; but this is often associated with significant patient morbidity. The relatively high recurrence rate of ameloblastoma is influenced by the type of molecular etiological factors, the management approach, and how early the patient presents for treatment. It is expected that further elucidation of molecular factors that orchestrate pathogenesis and recurrence of ameloblastoma will lead to new diagnostic markers and targeted drug therapies for ameloblastoma.
成釉细胞瘤是一种良性牙源性上皮来源的肿瘤。它具有局部侵袭性和无限生长能力,并且具有恶性转化和转移的高潜力。虽然大多数患者年龄在 30 岁至 60 岁之间,但目前尚无确定的预防措施。促进牙源性上皮向成釉细胞瘤发生癌变的分子和遗传因素与与丝裂原活化蛋白激酶、刺猬信号通路和 WNT/β-连环蛋白信号通路相关的多个基因的失调密切相关。由于成釉细胞瘤具有高局部侵袭性,因此其治疗重点是手术切除,切除范围要包括正常组织的宽边缘;但这通常会导致患者出现明显的发病率。成釉细胞瘤相对较高的复发率受到分子病因因素的类型、管理方法以及患者接受治疗的时间早晚的影响。预计对协调成釉细胞瘤发病机制和复发的分子因素的进一步阐明将为成釉细胞瘤带来新的诊断标志物和靶向药物治疗。