Liu X-H, Zhong N-N, Yi J-R, Lin H, Liu B, Man Q-W
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
Department of Oral & Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
J Dent Res. 2025 Apr;104(4):347-368. doi: 10.1177/00220345241282256. Epub 2025 Jan 28.
Odontogenic keratocyst (OKC) and ameloblastoma (AM) are common jaw lesions with high bone-destructive potential and recurrence rates. Recent advancements in technology led to significant progress in understanding these conditions. Single-cell and spatial omics have improved insights into the tumor microenvironment and cellular heterogeneity in OKC and AM. Fibroblast subsets in OKC and tumor cell subsets in AM have been analyzed, revealing mechanisms behind their biological behaviors, including OKC's osteolytic features and AM's recurrence tendencies. Spatial transcriptomics studies of AM have identified engineered fibroblasts and osteoblasts contributing to matrix remodeling gene and oncogene expression at the invasion frontier, driving AM progression. Three-dimensional culture technologies such as organoid models have refined analysis of AM subtypes; uncovered the role of AM fibroblasts in promoting tumor cell proliferation and invasion; and identified signaling pathways such as FOSL1, BRD4, EZH2, and Wnt as potential therapeutic targets. Organoid models also served as preclinical platforms for testing potential therapies. Although preclinical models for AM exist, reliable in vitro and in vivo models for OKC remain scarce. Promising mimic models, including human embryonic stem cells-derived epithelial cells, human oral keratinocytes, human immortalized oral epithelial cells, and HaCaT keratinocytes, show promise, but the advancements in 3-dimensional culture technology are expected to lead to further breakthroughs in this area. Artificial intelligence, including machine learning and deep learning, has enhanced radiomics-based diagnostic accuracy, distinguishing OKC and AM beyond clinician capability. Pathomics-based models further predict OKC prognosis and differentiate AM from ameloblastic carcinoma. Clinical studies have shown positive outcomes with targeted therapies. In a study investigating SMO-targeted treatments for nevoid basal cell carcinoma syndrome, nearly all OKC lesions resolved in 3 patients. A recent clinical trial with neoadjuvant BRAF-targeted therapy for AM demonstrated promising radiologic responses, potentially enabling organ preservation. This review highlights recent advancements and trends in OKC and AM research, aiming to inspire further exploration and progress in these fields.
牙源性角化囊肿(OKC)和成釉细胞瘤(AM)是常见的颌骨病变,具有较高的骨破坏潜力和复发率。技术的最新进展在理解这些病症方面取得了重大进展。单细胞和空间组学提高了对OKC和AM肿瘤微环境及细胞异质性的认识。对OKC中的成纤维细胞亚群和AM中的肿瘤细胞亚群进行了分析,揭示了它们生物学行为背后的机制,包括OKC的溶骨特征和AM的复发倾向。AM的空间转录组学研究确定了工程化的成纤维细胞和成骨细胞在侵袭前沿促成基质重塑基因和癌基因表达,推动AM进展。类器官模型等三维培养技术完善了对AM亚型的分析;揭示了AM成纤维细胞在促进肿瘤细胞增殖和侵袭中的作用;并确定了FOSL1、BRD4、EZH2和Wnt等信号通路作为潜在治疗靶点。类器官模型还作为测试潜在疗法的临床前平台。虽然存在AM的临床前模型,但可靠的OKC体外和体内模型仍然稀缺。有前景的模拟模型,包括人胚胎干细胞衍生的上皮细胞、人口腔角质形成细胞、人永生化口腔上皮细胞和HaCaT角质形成细胞,显示出前景,但三维培养技术的进步有望在该领域带来进一步突破。包括机器学习和深度学习在内的人工智能提高了基于放射组学的诊断准确性,超越临床医生能力区分OKC和AM。基于病理组学的模型进一步预测OKC预后并将AM与成釉细胞癌区分开来。临床研究表明靶向治疗取得了积极成果。在一项针对痣样基底细胞癌综合征的SMO靶向治疗的研究中,3名患者的几乎所有OKC病变均得到解决。最近一项针对AM的新辅助BRAF靶向治疗的临床试验显示出有前景的放射学反应,有可能实现器官保留。本综述强调了OKC和AM研究的最新进展和趋势,旨在激发这些领域的进一步探索和进展。