AĞIZ, DİŞ VE ÇENE PATOLOJİLERİNİN KESİN TANISINDA İMMÜNOHİSTOKİMYASAL ANALİZİN GEREKLİLİĞİ

Yıl 2019, Cilt: 46 Sayı: 2, 69 - 76, 01.08.2019

Sıdıka Sinem Akdeniz Burak Bulmuş

Öz

Oral kavite ve çene-yüz bölgesinde görülen patolojilerin ayırıcı tanısı prognozu belirleme, nüks etme eğilimini yorumlama ve doğru cerrahi tedavinin uygulanabilmesi açısından önemlidir. Oral patolojilerin tanısı klinik ve radyolojik özelliklerle ilişkili olsa da, kesin tanı histopatolojik incelemeye dayanmaktadır. Bu retrospektif çalışma 2011-2017 yılları arasında Başkent Üniversitesi Ağız Diş ve Çene Cerrahisi Bölümünde tedavi görmüş hasta verilerinin histopatolojik raporları üzerinden gerçekleştirildi. Çalışmaya toplamda 579 adet odontojenik ve odotojenik olmayan kist ve tumor vakası dahil edildi. Bu örnekler kist ve tümörün tipi, yaş, cinsiyet ve immünohistokimyasal boyama dağılımı açısından analiz edildi. Kesin tanı için 20 (% 3) olguda immünhistokimyasal analiz gerektiği görüldü. Sitokeratin AE1 / AE3, S100, CD68 ve Ki-67’nin oral ve maksillofasiyal bölgedeki kist ve tümörlerin kesin tanısını koymada en çok tercih edilen immünohistokimyasal antikorlar olduğu belirlendi. Odontojenik kistlerin kesin tanısı için immunohistokimyasal analize gerek duyulmadığı belirlendi.

Anahtar Kelimeler

odontojenik kist, odontojenik tümör, oral patoloji, immünohistokimyasal analiz

The Necessity of Immunohistochemical Analysis for Definitive Diagnosis of Oral and Maxillofacial Pathologies

Öz

The differential diagnosis of pathologies in the oral cavity and jmaxillofacial region is important in determining prognosis, interpreting the tendency to relapse, and the correct surgical treatment. Although the diagnosis of oral pathologies is related to clinical and radiological features, the definitive diagnosis is based on histopathological examination. This retrospective study was performed based on histopathological reports of patients treated in Başkent University Department of Oral and Maxillofacial Surgery between 2011-2017. A total of 579 cases of odontogenic and non-odotogenic cysts and tumors were included in the study. These samples were analyzed for cyst and tumor type, age, sex and distribution of immunohistochemical staining. Immunohistochemical analysis was necessary in 20 (3%) cases for definitive diagnosis.
Cytokeratin AE1 / AE3, S100, CD68 and Ki-67 were found to be the most preferred immunohistochemical antibodies for the definitive diagnosis of cysts and tumors in the oral and maxillofacial regions. Immunohistochemical analysis was not necessary for the definitive diagnosis of odontogenic cysts.

Anahtar Kelimeler

odontogenic cyst, odontogenic tumors, oral pathology, immunohitochemical analysis

Kaynakça

• Ledesma-Montes C, Hernandez-Guerrero JC, Garces-Ortiz M. Clinico-pathologic study of odontogenic cysts in a Mexican sample population. Arch Med Res. 2000;31:373- 376.
• Shear M, Speight P. Cysts of the Oral and Maxillofacial Regions. Ames, IA: WileyBlackwell; 2007.
• Tekkesin MS, Olgac V, Aksakalli N, Alatli C. Odontogenic and nonodontogenic cysts in Istanbul: analysis of 5088 cases. Head Neck Pathol. 2012;34:852-855.
• Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 3rd ed. Missouri: Saunders Elsiever Inc; 2009.
• Bilodeau EA, Collins BM. Odontogenic Cysts and Neoplasms. Surg Pathol Clin. 2017 ;10:177-222.
• Wright JM, Vered M. Update from the 4th edition of the world health organization classification of head and neck tumours: Odontogenic and maxillofacial bone tumors. Head Neck Pathol. 2017;11:68–77.
• Jeyaraj P. The dilemma of extensive unilocular radiolucent lesions of the jaws - value of immunohistochemistry as a diagnostic marker and prognostic Indicator. Ann Diagn Pathol. 2019;40:105-135.
• Heikinheimo K, Hormia M, Stenman G, Virtanen I, Happonen RP. Patterns of expression of intermediate filaments in ameloblastoma and human fetal tooth germ. J Oral Pathol Med. 1989; 18: 264–273.
• Yoon HJ, Jo BC, Shin WJ, Cho YA, Lee JI, Hong SP et al. Comparative immunohistochemical study of ameloblastoma and ameloblastic carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:767-776.
• Kishino M, Murakami S, Yuki M, Lida S, Ogawa Y, Kogo M et al. A immunohistochemical study of the peripheral ameloblastoma. Oral Dis. 2007; 13: 575–580.
• Kureel K, Urs AB, Augustine J. Cytokeratin and fibronectin expression in orthokeratinized odontogenic cyst: A comparative immunohistochemical study. J Oral Maxillofac Pathol. 2019; 23:65-72.
• Ferreira Lopes F, Fontoura MC, do Amaral AL, Dantas EJ, Cavalcanti H, Batista L et al. Análise imuno-histoquímica das citoqueratinas em ameloblastoma e tumor odontogênico adenomatóide. J Bras Patol Med Lab. 2005; 41: 425–430.
• Leon JE, Mata GM, Fregnani ER, CarlosBregni R, de Almeida OP, Mosqueda Taylor A et al. Clinicopathological and immunohistochemical study of 39 cases of Adenomatoid Odontogenic Tumour: a multicentric study. Oral Oncol. 2005; 41: 835–842.
• Bader BL, Magin TM, Hatzfeld M, Franke WW. Amino acid sequence and gene organization of cytokeratin no. 19, an exceptional tail-less intermediate filament protein. EMBO J. 1986; 5: 1865– 1875.
• Kuberappa PH, Bagalad BS, Ananthaneni A, Kiresur A, Srinivas GV. Certainty of S100 from Physiology to Pathology. J Clin Diagn Res. 2016; 10: 10–15.
• Sargolzaei S, Taghavi N, Poursafar F. Are CD68 and Factor VIII-RA Expression Different in Central and Peripheral Giant Cell Granuloma of Jaw: An Immunohistochemical Comparative Study. Turk Patoloji Derg. 2017;1:49-56.
• Bullwinkel J, Baron-Lühr B, Lüdemann A, Wohlenberg C, Gerdes J, Scholzen T. Ki-67 protein is associated with ribosomal RNA transcription in quiescent and proliferating cells. J Cell Physiol. 2006;206:624-635.
• Sreedhar G, Raju MV, Metta KK, Manjunath S, Shetty S, Agarwal RK. Immunohistochemical analysis of factors related to apoptosis and cellular proliferation in relation to inflammation in dentigerous and odontogenic keratocyst. J Nat Sci Biol Med. 2014;5:112-115.
• Singh H, Shetty D, Kumar A, Chavan R, Shori D, Mali J. A molecular insight into the role of inflammation in the behavior and pathogenesis of odontogenic cysts. Ann Med Health Sci Res. 2013;3:523-528.
• Shear M. The aggressive nature of the odontogenic keratocyst: is it a benign cystic neoplasm? Part 2. Proliferation and genetic studies. Oral Oncol. 2002;38:323-31.
• Li TJ, Browne RM, Matthews JB. Epithelial cell proliferation in odontogenic keratocysts: a comparative immunocytochemical study of Ki67 in simple, recurrent and basal cell naevus syndrome (BCNS)-associated lesions. J OralPathol Med. 1995;24:221-6.
• Park S, Nam SJ, Keam B, Kim TM, Jeon YK, Lee SH, Hah JH, Kwon TK, Kim DW, Sung MW, Heo DS, Bang YJ. VEGF and Ki-67 Overexpression in Predicting Poor Overall Survival in Adenoid Cystic Carcinoma. Cancer Res Treat. 2016 ;48:518-26.