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. 2024 Oct 15;18(1):100.
doi: 10.1007/s12105-024-01705-7.

Immunohistochemical Expression of MDM2, Bcl-2, SATB2 and Ki-67 in Histological Variants of Unicystic Ameloblastoma

Koustubh Amol Surana  1 , Deepak Pandiar  2 , Reshma Poothakulath Krishnan  1
Affiliations

Immunohistochemical Expression of MDM2, Bcl-2, SATB2 and Ki-67 in Histological Variants of Unicystic Ameloblastoma

Koustubh Amol Surana et al. Head Neck Pathol. .

Abstract

Aim: To characterize the immunohistochemical expression of MDM2, Bcl-2, SATB2 and Ki-67 in histological variants of unicystic ameloblastoma (UA).

Methodology: Following the ethical approval, forty (40) patients with unicystic ameloblastoma were retrieved from the archives and subjected to immunohistochemistry (IHC). Sociodemographic and clinical data were also retrieved. The results were entered into a Microsoft Excel spreadsheet and analyzed using SPSS software.

Results: Human tooth germs, which served as the control, showed moderate expression of Bcl-2 and MDM2 with slight proliferative activity in ameloblasts and moderate expression of SATB2 in ectomesenchyme and odontoblasts. Luminal UA (Type 1) showed low Ki-67 index and negative to mild Bcl-2 and MDM2 expression, whilst Type 1.2 (luminal and intraluminal), Type 1.2.3 (luminal, intraluminal and mural), and Type 1.3 (luminal and mural), including the recurrent cases, showed moderate to intense expression with high mean Ki-67 index. The difference between the study groups was statistically significant (p value < 0.001). No expression of SATB2 was noted in any histological variant of UA. Furthermore, no significant differences were noted in age, gender, site and location between the groups.

Conclusion: In contrast to luminal variant of UA, mural±intraluminal variants and recurrent cases demonstrate higher expression of Bcl-2 and MDM2 with higher mean Ki-67 index. It may thus be prudent to provide aggressive treatment for cases, not just with mural follicles but also for the patients with intraluminal plexiform proliferation, to prevent recurrence and improve patient outcomes.

Keywords: Bcl-2; Immunohistochemistry; MDM2; Unicystic Ameloblastoma.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
(a) Panoramic radiograph showing a large expansile unilocular radiolucent lesion in a case of unicystic ameloblastoma involving the body and angle of the left mandible with root resorption; (b) Grossly a single cavity was noted with some nodules on the wall; Photomicrograph of H& E stained sections showing Type 1 UA with extensive juxtaepithelial hyalinisation (c, 100X), intraluminal proliferation (d, 100X), luminal and mural proliferation (e, 100X) and extensive involvement of peripheral bone by mural follicles (f, 100X)
Fig. 2
Fig. 2
Photomicrograph of IHC sections showing the expression of Ki-67 (a), MDM2 (b), Bcl-2 (c) and SATB2 (c) in tooth germ
Fig. 3
Fig. 3
Photomicrograph of IHC sections showing (a) nuclear Ki-67 expression in type 1 UA (arrow) and (b) type 1.2; (c) showing SATB2 nuclear expression in the stromal cells near the peripheral bone; (d-f) nuclear expression of MDM2 in type 1 UA (moderate basal and parabasal), Type 1.2 UA and Type 1.3 UA; (g-h) Bcl-2 immunoexpression in luminal, intraluminal and mural UA
See this image and copyright information in PMC

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