Journal of Isfahan Dental School

Immunohistochemical Evaluation of CK19 Tumor Marker in Inflamed and Non Inflamed Odontogenic Keratocyst Groups

Document Type : مقاله‌های پژوهشی

Authors

1 Graduate, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

2 Dental Implants Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan. Iran

3 Department of Oral and Maxillofacial Pathology, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran

Abstract

Introduction: Odontogenic keratocyst (OKC) or keratocystic odontogenic tumor (KCOT) is a developmental odontogenic cyst which requires special attention due to its unique clinical and histopathological features. CK19 is expressed in non-keratinized normal epithelium and its expression increases during inflammation. Recently the use of this tumor marker has been suggested for identification of odontogenic cysts and tumors. Thus the aim of the present study was to evaluate the expression of CK19 in inflammatory and non-inflammatory keratocyst epithelial cells.
Materials and Methods: This retrospective cross-sectional study was performed immunohistochemically on 25 inflamed and non-inflamed OKC paraffin blocks retrieved from the Archives of the Oral Pathology Laboratories of Isfahan Azad University and Isfahan University of Medical Sciences Medical Faculties. After selecting the samples, sections measuring 3‒5 µm in thickness were prepared. The intensity of cytoplasmic stainability was studied immunohistochemically in three different layers of cyst epithelium: basal, suprabasal and superficial under a light microscope at ×10 and ×40. Data were analyzed with Mann-Whitney test using SPSS 20 (α = 0.05).
Results: Expression of CK19 was seen in 100% of inflammatory OKCs and 84% of non-inflammatory OKCs. In inflamed OKCs expression of CK19 was seen in all the three layers of epithelium; however, in non-inflamed OKCs expression of CK19 was seen in the middle layer in only one sample (p value < 0.001).
Conclusion: According to the results of the present study, CK19 was expressed in both inflammatory and non-inflammatory OKCs; however, the intensity of staining was different between the groups. In contrast to oral mucosal lesions CK19 was expressed in keratinized odontogenic epithelium. In odontogenic keratocyst, expression of CK19 was seen in response to inflammation as seen in oral lesions.
Key words: Immunohistochemistry, Odontogenic cyst, Inflammation, Keratin-19

1. Neville BW, Damm DD, Allen CM, Chi AC, Elsevier. Oral and maxillofacial pathology. St. Louis: Elsevier Health Sciences; 2015.
2. Sudiono J, Zain RB. PCNA expression in epithelial linings of odontogenic cysts. Ann Dent UM 2003; 10(1): 1-5.
3. Brondum N, Jensen VJ. Recurrence of keratocysts and decompressiontreatment. A long-term follow-up of forty-four cases. Oral Surg Oral Med Oral Pathol 1991; 72(3): 265-9.
4. Kaplan I, Hirshberg A. The correlation between epithelial cell proliferation and inflammation in odontogenic keratocyst. Oral Oncol 2004; 40(10): 985-91.
5. Hunter KD, Speight PM. The diagnostic usefulness of immunohistochemistry for odontogenic lesions. Head Neck Pathol 2014; 8(4): 392-9.
6. Stoll C, Stollenwerk C, Riediger D, Mittermayer C, Alfer J. Cytokeratin expression patterns for distinction of odontogenic keratocysts from dentigerous and radicular cysts. J Oral Pathol Med 2005; 34(9): 558-64.
7. Heyl J, Mehregan D. Immunolabeling pattern of cytokeratin 19 expression may distinguish sebaceous tumors from basal cell carcinomas. J Cutan Pathol 2008; 35(1): 40-5.
8. Aminzadeh A, Razavi SM, Sabeti Sanat A. Immunohistochemical evaluation of expression of CK19 premalignant indicator in Oral Lichenoid Reaction (OLR) compared to Oral Lichen Planus (OLP), Oral Squamous Cell Carcinoma (OSCC) and normal oral mucosa. J Isfahan Dent Sch 2018; 14(1): 17-28. [In Persian].
9. Premalatha BR, Patil S, Rao RS, Reddy NP, Indu M. Odontogenic tumor markers - an overview. J Int Oral Health 2013; 5(2): 59-69.
10. Mosqueda-Taylor A. New findings and controversies in odontogenic tumors. Med Oral Patol Oral Cir Bucal 2008; 13(9): E555-8.
11. Kamath KP, Vidya M. Cytokeratin 19 expression patterns of dentigerous cysts and odontogenic keratocysts. Ann Med Health Sci Res 2015; 5(2): 119-23.
12. Browne RM. Investigative pathology of the odontogenic cysts. Boca Raton, Fl: CRC Press; 1990.
13. Lindberg K, Rheinwald JG. Suprabasal 40 kd keratin (K19) expression as an immunohistologic marker of premalignancy in oral epithelium. Am J Pathol 1989; 134(1): 89-98.
14. van Sprundel RGHM, van den Ingh TSGAM, Desmet VJ, Katoonizadeh A, Penning LC, Rothuizen J, et al. Keratin 19 marks poor differentiation and a more aggressive behaviour in canine and human hepatocellular tumours. Comp Hepatol 2010; 9: 4.
15. Nie M, Zhong L, Zeng G, Li B. The changes of cytokeratin 19 during oral carcinogenesis. Zhonghua Kou Qiang Yi Xue Za Zhi 2002; 37(3): 187-90.
16. Kawai S, Ito E, Yamaguchi A, Eishi Y, Okada N. Immunohistochemical characteristics of odontogenic carcinomas: their use in diagnosing and elucidating histogenesis. J Oral Pathol Med 2009; 13(2): 55-63.
17. Ide F, Kikuchi K, Miyazaki Y, Mishima K, Saito I, Kusama K. Keratocyst of the buccal mucosa: is it odontogenic? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(5): e42-7.
18. Tsuji K, Wato M, Hayashi T, Yasuda N, Matsushita T, Ito T, et al. The expression of cytokeratin in keratocystic odontogenic tumor, orthokeratinized odontogenic cyst, dentigerous cyst, radicular cyst and dermoid cyst. Med Mol Morphol 2014; 47(3): 156-61.
19. Bhakhar VP, Shah VS, Ghanchi MJ, Gosavi SS, Srivastava HM, Pachore NJ. A comparative analysis of cytokeratin 18 and 19 expressions in odontogenic keratocyst, dentigerous cyst and radicular cyst with a review of literature. J Clin Diagn Res 2016; 10(7): ZC85-9.
20. Dos Santos JN, Oliveira GQ, Gurgel CA, de Souza RO, Sales CB, de Aguiar Pires Valença Neto A, et al. Altered expression of cytokeratins in primary, recurrent and syndrome keratocystic odontogenic tumors. J Mol Histol 2009; 40(4): 269-75.
21. Moshref M, Sargolzaei S, Mashhadi abas F, Mojtahedi AA. Evaluation of expression & intensity of cytiokeratin-10 and 19 in Odontogenic Keratocyst (OKC) with immunohistochemical staining and comparing it with dentigerous cyst & dental follicle. Pajoohandeh 2007; 12(2): 115-21. [In Persian].
Journal of Isfahan Dental School
Volume 15, Issue 2 - Serial Number 2
May 2019
Pages 130-137