Study of epidermal growth factor receptor)EGFR) expression in benign and malignant Ameloblastoma Of The Jaws

Abstract

Introduction: Ameloblastoma is a rare odontogenic neoplasm of the mandible and maxilla, with multiple histological variants, and high recurrence rates if improperly treated. It is a locally invasive neoplasm often associated with morbidity and facial deformities, showing increased epidermal growth factor receptor (EGFR) expression. EGFR stain location plays a vital role in assessing its proliferative potential, biological aggressiveness and treatment options. This study was aimed to assess the clinic- histopathological features of the ameloblastoma cases and to study (Immunohistochemistry examination) the immune -expression of EGFR in ameloblastoma cases to clarify their role in the biological behavior of the benign and malignant ameloblastoma. Materials and Methods: A descriptive case-series study of twenty-five patients diagnosed as ameloblastomas was conducted during the period from 1995 to 2010.The present study was undertaken in oral pathology laboratory at Faculty of Dentistry, University of Benghazi. The data were collected and reviewed from patients' charts. Clinical and epidemiological data were taken. Histopathological examination and Immunohistochemistry were done. The immune expression of EGFR reaction in ameloblastomas were positive or negative reaction. Data collected and then analyzed by Statistical program (SPSS). Results: The age of the subjects ranged from15 to 50 years with mean age 29.1 and SD 10.586 years. M:F ratio 1.5:1. More than half of cases of ameloblastomas mainly in right side of the mandible, while 44 % in left side of the mandible, and only 4% in both sides. Histopathological examination. Most cases were cystic 48 %, plexiform represents 32 % whereas, follicular and desmoplastic were seen in 16% and 4% of cases respectively. granular cell, acanthomatous and basal cell were not observed in the ameloblastoma. The ameloblastomas. cases (21) 86% were positively stained immune reactions to EGFR. The cells were observed mainly in combined of cytoplasmic and membranous followed by membranous, while nearly (only 4 lesions) represent 14% were negative staining. Conclusions and Recommendations: The study concluded that most of ameloblastomas appear most commonly in the third to fifth decades. The majority of ameloblastomas indicate the biological behavior of the tumors as an aggressive because, most of tumors were solid and multicystic based on their histological classification, rather than benign also frequently invade locally and no metastasize was recorded . The majority of ameloblastoma are positive for immune reaction to EGFR, about 9 cases combind cytoplasmic and membranous, 4 cases combined nuclear, cytoplasamic and membranous, 8 cases membranous. The distribution of EGFR expression in ameloblsatoma 48% focal reaction, 40% diffuse reaction, 12% negative reaction. The staining intensity of EGFR 6 cases strong positive staining, 11cases moderate positive staining, 4 cases weak staining, 4 cases negative reaction.