Decompression of keratocystic odontogenic tumors leads to increased fibrosis, but no change in epithelial proliferation

Publication date: Available online 30 December 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): S. Awni, B. Conn
ObjectiveInvestigation into whether decompression treatment induces changes in histology or biological behaviour in KCOT.Study design17 patients with KCOT had decompression treatment alone or with enucleation. Histological evaluation and immunohistochemical expression of p53, Ki-67and Bcl-2 were analysed using conventional microscopy.ResultsKCOT showed significantly increased fibrosis (p=0.01) and a subjective reduction in mitotic activity (P=0.03) after decompression. There were no statistically significant changes in the expression of proliferation markers. An increase in daughter-cysts / epithelial rests was seen after decompression (p=0.04). Recurrence was noted in 4/16 cases, there was a strong correlation between expression of p53 with prolonged duration of treatment (p= 0.01) and intense inflammatory changes (P=0.02).ConclusionStructural changes in the KCOT epithelium/capsule following decompression facilitate the surgical removal. There was no statistical evidence that decompression influences expression of proliferation markers in the lining, indicating that the potential for recurrence may not be restricted to the cellular level. The statistically significant increase of p53 expression with increased duration of treatment and of inflammation may also indicate the possibility of higher rates of recurrence with prolonged treatment and significant inflammatory changes.



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