IMMUNOHISTOCHEMICALSTUDY FOR BCL-2 IN ODONTOGENIC KERATOCYST

Abstract

Introduction: The odontogenickeratocyst (OKC) is a relatively uncommon lesion which has much interest because of its unusual growth pattern and tendency to recur. The majority of odontogenickeratocysts arise sporadically and present as solitary lesions unless they are associated with nevoid basal cell carcinoma syndrome,although occurs in any part of jaws the majority of themfound in the mandible; most commonly in the posterior body and ascending ramus. OdontogenicKeratocycts present an aggressive clinical course with a marked trendtoward recurrence as compared with dentigerous cysts, differences in the clinical behavior of cysts may be associated with apoptosis in the lining epithelium. Aim of Study: 1-To analyze the clincohistopathological features of the OdontogenicKeratocyst cases. 2- To study the immunoexpression ofBcl-2 inOdontogenicKeratocyst. Materials and Methods: A descriptive case- series study. Sample size were twenty casesdiagnosed OKC ranged from 18 -65 years M: F ratio 1.9: 1,the personal data such as age, sexsite, residence, nationality of the patients were noted from the patients recordes,the samples were taken from wax blocks ,cut and stained,four microns thick sections were cut and stained with Hematoxylin and Eosin (H & E) then stained by immune marker Bcl2 in the oral pathology department at university of Alexandria- Egypt to study immune reactions, finally the data were collected and analyzedusing statistical package social science (SPSS) version 17. Results: The histopathological appearance of OKCS , characterized by thin stratified squamous epithelium in the majority of cases. Most of OKCs showed a palisaded basal cell layer. The surface layer of cyst lining wereparakeratinized and only few were orthokeratinized,cyst wall contained the following: Inflammatory cell were (75%) of cases,Satellite cysts were(40%) of cases, epithelial residues in (40%) of cases,Kerattinesquames in (60%) of cases. Regarding immune histochemical finding, theBcl-2 expression positive cells was 75% of the lesions were classified into three grades weak , moderate and intense reactions in 20 %, 33.3 % & 46.6 % respectively. Conclusion: Inconclusion OKCs were solitary, the majority of OKC seems to be biologically aggressive and should be classified as a tumour rather than a cyst. Because the majority of OKCs were with high proliferative activity and characterized by higher expression of Bcl-2 in basal cell epithelium, probably that lesions are developmental cysts with some neoplastic properties. We recommend to complete the medical files in the archive of oral pathology department to include all data such as onset of symptom, duration of lesions , if there is any associateddiseases and the report of radiography.