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Abstract
Purpose
The odontogenic keratocysts demonstrated a high recurrence rate and a biologically aggressive nature. This might be due to unknown factors inherent in the epithelium or enzymatic activity in the fibrous wall. Bcl-2 protein is characterized by its ability to inhibit apoptosis. The aim of this study was to evaluate the expression and distribution of bcl-2 in the OKCs, its possible relationship with the tumorous characteristics, such as the aggressive nature and high recurrence rate, and its usefulness to differentiate OKCs from dentigerous cysts.
Materials and Methods
Formalin fixed paraffin-embedded tissue sections of 53 OKCs, and 44 dentigerous cyst were immunohistochemically analyzed quantitatively for the immunoreactivity of the bcl-2 protein with i-solution.
Results
More Bcl-2 expression was observed in the OKCs (mean34.387%) than dentigerous cyst (mean11.144%) with statistical significance (P<0.001). Seventeen and 15 of the 32 OKCs in this study showed positivity in the basal layer and basal/suprabasal layers, respectively. In dentigerous cyst, 2 of 3 showed positivity in the basal cell layer.
Conclusion
Considering that bcl-2 over expression may lead to the increased survival of epithelial cells, this study demonstrated a possible relationship between the aggressive nature of OKC and the intrinsic growth potential of its lining epithelium. Furthermore, the basal/suprabasal distribution of bcl-2 positive cells was observed in some OKCs, which might have a significant impact on the behavior of cysts. The bcl-2 expression of OKCs can be useful for differentiating OKCs from dentigerous cysts.
References
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Fig. 2.
Photomicrograph of the epithelium of the OKC. Maximum intensity of immunohistochemical expression of bcl-2 and basal and suprabasal cells are positive for bcl-2. (Hematoxylin Orig. ×40)
Fig. 3.
Photomicrograph of the epithelium of the OKC. Mean intensity of immunohistochemical expression of bcl-2 and basal cells are positive for bcl-2.(Hematoxylin Orig. ×40)
Fig. 4.
Photomicrograph of the epithelium of the OKC. No expression of bcl-2.(Hematoxylin Orig. ×40)
Fig. 5.
Photomicrograph of the epithelium of the dentigerous cyst. Maximum Immunohistochemical expression of bcl-2 and basal and suprabasal cells are positive for bcl-2. (Hematoxylin Orig. × 40)
Fig. 6.
Photomicrograph of the epithelium of the Dentigerous cyst. Immuno-histochemical expression of bcl-2 and basal cells are positive for bcl-2.(Hematoxylin Orig. ×40)
Fig. 7.
Photomicrograph of the epithelium of the dentigerous cyst. No expression of bcl-2.(Hematoxylin Orig. ×40)
Table 1.
Distribution of age and gender
Table 2.
Distribution of anatomic location
| Location | No. of cases | % | |
|---|---|---|---|
| Maxilla | 1 | 5 | 5.1 |
| 2 | 6 | 6.2 | |
| 3 | 11 | 11.2 | |
| Mandible | 4 | 21 | 21.4 |
| 5 | 7 | 7.1 | |
| 6 | 6 | 6.2 | |
| 7 | 12 | 12.2 | |
| 8 | 30 | 30.6 | |
| Total | 98 | 100 | |
Table 3.
Radiologic finding
| Radiologic finding | Unilocular | Multilocular | Total |
|---|---|---|---|
| Smooth | 53 | 1 | 54 (55.1%) |
| Scalloped | 25 | 19 | 44 (44.9%) |
| Total | 78 (79.6%) | 20 (20.4%) | 98 (100%) |
Table 4.
Immunohistochemical expression of bcl-2
| Expression of bcl-2 | Odontogenic keratocyst | Dentigerous cyst | ||
|---|---|---|---|---|
| No. of cases | % | No. of cases | % | |
| Yes | 32 | 60.4 | 3 | 6.8 |
| No | 21 | 39.6 | 41 | 93.2 |
| Total | 53 | 100 | 44 | 100 |
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