Singh Thasvir, Chandu Arun, Clement John, Angel Christopher
Oral and Maxillofacial Surgery Office C/- 2 North, Royal Melbourne Hospital, Parkville, VIC 3050 Australia.
Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3053 Australia.
J Maxillofac Oral Surg. 2017 Mar;16(1):65-70. doi: 10.1007/s12663-016-0923-5. Epub 2016 Jun 2.
The aims of this study are to elucidate if molecular markers can be used to differentiate between the two main types of ameloblastoma (unicystic and solid/multicystic), and to determine whether a biologically 'less-aggressive' subtype exists.
A retrospective analysis of 33 solid/multicystic ameloblastomas and six unicystic ameloblastomas was completed using immunohistochemistry for five molecular markers: P16, P53, MMP-9, Survivin, and Ki-67. Tumors were graded as either negative or positive (mild, moderate, strong), and the results were related to both ameloblastoma subtypes and outcomes following treatment.
Unicystic ameloblastomas were more likely to test strongly positive for P53 than solid/multicystic ameloblastomas ( < 0.05), whereas the latter were more likely to be negative for Survivin ( < 0.05). Solid/multicystic and Type 3 unicystic ameloblastomas that were positive for P16, but also negative for MMP-9 and Survivin, were less likely to recur than all other tumors ( < 0.05). The proliferation index of an ameloblastic carcinoma (11 %) was shown to be higher than benign ameloblastomas (4.5 %).
Immunohistochemistry can be valuable in lesions where histological sub-typing of an ameloblastoma is unclear. A biologically 'less-aggressive' subtype may exist, and hence further research into this area is required.
本研究的目的是阐明分子标志物是否可用于区分两种主要类型的成釉细胞瘤（单囊性和实性/多囊性），并确定是否存在生物学上“侵袭性较小”的亚型。
对33例实性/多囊性成釉细胞瘤和6例单囊性成釉细胞瘤进行回顾性分析，使用免疫组织化学检测5种分子标志物：P16、P53、基质金属蛋白酶-9（MMP-9）、生存素（Survivin）和Ki-67。肿瘤分级为阴性或阳性（轻度、中度、强阳性），结果与成釉细胞瘤的两种亚型及治疗后的结果相关。
单囊性成釉细胞瘤P53检测呈强阳性的可能性高于实性/多囊性成釉细胞瘤（P<0.05），而后者Survivin检测呈阴性的可能性更大（P<0.05）。P16阳性、MMP-9和Survivin阴性的实性/多囊性及3型单囊性成釉细胞瘤复发的可能性低于所有其他肿瘤（P<0.05）。成釉细胞癌的增殖指数（11%）高于良性成釉细胞瘤（4.5%）。
在成釉细胞瘤组织学亚型不明确的病变中，免疫组织化学可能有价值。可能存在生物学上“侵袭性较小”的亚型，因此需要对该领域进行进一步研究。
