歯原性角化嚢胞の臨床および免疫組織学的研究

抄録

Odontogenic keratocysts have some characteristics distinguishing them from other types of odontogenic cysts. These characteristics include as the development of multiple cysts, occasional association with basal cell nevi syndrome (BCNS), and a high incidence of recurrence clinically, and budding proliferation of the epithelium and the formation of islands of odontogenic epithelium and daughter cysts histopathologically. We studied the growth potential of the epithelial lining of odontogenic keratocysts to gain insight into their biological properties, including potential tumor-like characteristics.
In this study, 51 odontogenic keratocysts in 28 patients were clinically reviewed, and 35 cysts in 20 patients were classified into the following 3 groups and were compared:(1) BCNS and non-BCNS cases, (2) multiple cysts and a single cyst, (3) recurrent and non-recurrent cases after cyst enucleation. Histopathological examinations using hematoxylin and eosin stain were performed to examine budding proliferation of the epithelium and the formation of islands of odontogenic epithelium and daughter cysts. In immunopathological studies using a monoclonal antibody of proliferating cell nuclear antigen (PCNA), the positive cell ratio of PCNA in the cyst epithelium was calculated. Our results were as follows:
1. Clinically 6 cases (21.4%) were associated with BCNS, 10 (35.7%) had multiple cysts, and 5 (17.9%) recurred.
2. Histopathologically the ratios of islands of odontogenic epithelium were higher in BCNS and multiple cyst cases than in non-BCNS and single cyst cases.
3. In immunopathological studies using a monoclonal antibody of PCNA, the ratios of positive PCNA cells in the basal layer of odontogenic epithelium in BCNS and multiple cyst cases were higher than those in non-BCNS and single cyst cases. These results suggest that the epithelium of BCNS and multiple cysts has high growth potential.