Robinson Liam, Smit Chané, van Heerden Marlene B, Ambele Melvin A, van Heerden Willie F P
Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Pretoria Oral Health Care Centre, Corner of Steve Biko and Dr Savage Roads, Pretoria, 0084, South Africa.
Head Neck Pathol. 2025 Jan 30;19(1):13. doi: 10.1007/s12105-024-01742-2.
This study aimed to investigate the role of DNA ploidy and proliferation index in distinguishing ameloblastoma (AB) from ameloblastic carcinoma (AC).
The study included 29 ACs, 6 conventional ABs that transformed into ACs, and a control cohort of 20 conventional ABs. The demographics and clinicopathologic details of the included cases were summarised and compared. The Ki-67 proliferation index was scored using the QuPath open-source software platform. DNA ploidy analysis was performed using high-resolution flow cytometry.
The cohort of ABs presented at an overall younger age compared to both primary and secondary ACs. There was a statistically significant difference between the median duration of the tumour when comparing primary and secondary ACs, with ACs presenting with longer durations than the AB cohort. All cases of AC showed a relatively high median proliferation index of 41.7%, with statistically significant higher scores compared to ABs. DNA ploidy analysis showed that all cases in the AB cohort were diploid. Two diploid cases of AB that transformed into ACs were aneuploid when the corresponding secondary AC was analysed. Fourteen cases of AC were diploid and 12 were aneuploid, with no statistically significant association found between DNA ploidy status of primary and secondary ACs. A statistically significant difference was noted when the DNA ploidy status of ABs was compared to that of ACs. When comparing the Ki-67 proliferation score of ACs to their DNA ploidy status, no statistically significant association was noted.
DNA ploidy analysis and proliferation index via Ki-67 IHC are useful ancillary tests that may be used to support a diagnosis of AC and may assist in distinguishing between challenging cases of AB and AC.
本研究旨在探讨DNA倍体和增殖指数在鉴别成釉细胞瘤（AB）和成釉细胞癌（AC）中的作用。
本研究纳入29例AC、6例转化为AC的传统AB以及20例传统AB作为对照队列。总结并比较纳入病例的人口统计学和临床病理细节。使用QuPath开源软件平台对Ki-67增殖指数进行评分。采用高分辨率流式细胞术进行DNA倍体分析。
与原发性和继发性AC相比，AB队列患者的总体年龄较轻。比较原发性和继发性AC时，肿瘤的中位病程存在统计学显著差异，AC的病程比AB队列更长。所有AC病例的中位增殖指数相对较高，为41.7%，与AB相比，得分具有统计学显著差异。DNA倍体分析显示，AB队列中的所有病例均为二倍体。当分析相应的继发性AC时，2例转化为AC的二倍体AB病例为非整倍体。14例AC为二倍体，12例为非整倍体，原发性和继发性AC的DNA倍体状态之间未发现统计学显著关联。将AB的DNA倍体状态与AC的进行比较时，发现存在统计学显著差异。比较AC的Ki-67增殖评分与其DNA倍体状态时，未发现统计学显著关联。
通过Ki-67免疫组化进行的DNA倍体分析和增殖指数是有用的辅助检查，可用于支持AC的诊断，并有助于鉴别AB和AC的疑难病例。
