BACKGROUND: Odontogenic keratocysts (OKCs) now reclassified as Keratocystic odontogenic tumours (KCOTs) are a clinical entity with a characteristic microscopic picture, kinetic growth and biological behaviour. They arise from the proliferation of the epithelial dental lamina in both maxilla and mandible and occur in patients of all ages. 70-80% of keratocysts are found in the mandible commonly in the angle between the jaw and mandibular branch and maxillary region of the third molar. The cysts are long latent, often symptomless and may attain remarkable dimensions without significant deformation of the jaw bones. They are often found during routine dental X-ray examination. Compared to other types of jaw cyst, odontogenic cysts have a striking tendency to rapid growth and re-occurrence. AIMS: This review focuses on the biological characteristics, clinical behaviour and treatment of KCOTs. METHODS: The databases searched were the PubMed interface of MEDLINE and LILACS. RESULTS AND CONCLUSIONS: Ondontogenic keratinocysts are not currently a diagnostic problem. Orthopantomograms which are today ordinary tools of dental investigation enable diagnosis of clinically asymptomatic cystic lesions. The problem remains the optimal therapeutic approach to reduce the still high likelihood of postoperative recurrence. There is no complete consensus on the ideal operating procedure but cystectomy with delayed extirpation is favoured. An open question also remains the timeliness of screening for postoperative recurrences. Given that the first clinical manifestation of Nevoid Basal Cell Carcioma Syndome (NBCCS) may be lesions of this type, routine histopathological classification supplemented by analysis of immunophenotype should be done. Patients with proven sporadic and especially syndromic OKC should be long term screened. In patients with NBCC preventive X ray examination is recommended only once a year.
- MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- nádory čelistí chemie diagnóza chirurgie MeSH
- odontogenní cysty chemie diagnóza chirurgie MeSH
- odontogenní nádory chemie diagnóza chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- nádorové biomarkery MeSH
TNF-alpha is a pleiotropic cytokine that is considered as a primary modifier of inflammatory and immune reaction in response to various inflammatory diseases and tumour. We investigated levels of TNF-alpha in 43 radicular cysts and 15 odontogenic keratocysts, obtained from patients undergoing surgery, under local anaesthesia, and after aspiration of cystic fluid from non-ruptured cysts. TNF-alpha is elevated in both cysts' fluid, but higher values were found in radicular cysts in comparison to keratocysts. The significantly higher concentration of TNF-alpha was associated with smaller radicular cysts, higher protein concentration, higher presence of inflammatory cells in peri cystic tissues, and the degree of vascularisation and cysts wall thickness (Mann-Whitney U-test, p < 0.05). No correlation was found based on these parameters in odontogenic keratocyst, but all cysts have detectable concentrations of TNF-alpha. We here for the first time present that a difference in the concentration of TNF-alpha exists between these two cystic types.
- MeSH
- cystická tekutina chemie MeSH
- lidé MeSH
- odontogenní cysty chemie MeSH
- radikulární cysta chemie MeSH
- TNF-alfa analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- TNF-alfa MeSH
BACKGROUND: The aim of this study was to analyse the usefulness of detecting important apoptosis and proliferation markers in assessing the biological potential of odontogenic keratocysts (OKC) and thus selecting the optimal diagnostic algorithm for these lesions. METHODS: Indirect immunohistochemistry and relevant statistical methods were used for analysis of formalin-fixed and paraffin-embedded samples from 98 patients. RESULTS: Nevoid basal cell carcinoma syndrome (NBCCS) keratocysts were characterized by higher expression of Bcl-2, p27Kip1 and c-erbB-2 as well as by lower proliferative activity measured by Ki-67 in basal cell epithelium and by a lower inflammatory response in comparison with sporadic keratocysts. Dentigerous, radicular and non-specified odontogenic cysts differed from both NBCCS and sporadic keratocysts in a wide spectrum of apoptosis and/or cell cycle-related protein expressions, higher proliferation in the basal cell layer, and vice versa, lower proliferation in the suprabasal cell layer. CONCLUSIONS: The NBCCS keratocysts have a different immunophenotype from sporadic keratocysts and both types are distinguishable from dentigerous, radicular and non-specified odontogenic cysts. These findings confirm the separate biological potential of these lesions and the results of the immunohistochemical analysis have diagnostic and prognostic implications.
- MeSH
- antigen Ki-67 analýza MeSH
- apoptóza fyziologie MeSH
- biologické markery analýza MeSH
- biologie MeSH
- dentigerózní cysta chemie patologie MeSH
- diferenciální diagnóza MeSH
- epitel chemie patologie MeSH
- imunofenotypizace MeSH
- imunohistochemie MeSH
- inhibitor p27 cyklin-dependentní kinasy analýza MeSH
- inhibitory proteinkinas analýza MeSH
- lidé MeSH
- odontogenní cysty chemie patologie MeSH
- prognóza MeSH
- proliferace buněk MeSH
- proteiny buněčného cyklu analýza MeSH
- proteiny regulující apoptózu analýza MeSH
- protoonkogenní proteiny c-bcl-2 analýza MeSH
- radikulární cysta chemie patologie MeSH
- receptor erbB-2 analýza MeSH
- syndrom bazocelulárního névu metabolismus patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- antigen Ki-67 MeSH
- biologické markery MeSH
- inhibitor p27 cyklin-dependentní kinasy MeSH
- inhibitory proteinkinas MeSH
- proteiny buněčného cyklu MeSH
- proteiny regulující apoptózu MeSH
- protoonkogenní proteiny c-bcl-2 MeSH
- receptor erbB-2 MeSH
