Age and expression of CD163 and CSF-1R/CD115 are associated with the biological behavior of central giant cell granuloma

Publication date: Available online 9 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Adrian Kahn, Gavriel Chaushu, Lana Ginene, Marilena Vered
ObjectiveCentral giant cell granulomas (CGCGs) are clinically classified as non-aggressive (nA-CGCG) and aggressive (A-CGCG). However, histopathologically all lesions feature spindle mononuclear cells (MCs) and multinuclear giant cells (GCs) in a hemorrhage-rich stroma. We aimed to investigate presence of cells with a monocyte/macrophage-related phenotype and together with clinical variables to examine their predictive potential for the biological behavior of CGCG.Patients and MethodsInvestigation was implemented a retrospective cohort study. Sections were immunohistochemically stained for colony stimulating factor–1 receptor (CSF-1R)/CD115, CD163, CD68 and nuclear factor kappa B (NF-kB). The clinical variables included age, gender and location of lesions. Association between immunostains and clinical variables and CGCG aggressiveness were analyzed by Wilcoxon–Mann–Whitney exact test and t-test. Significant variables were further analyzed by a logistic regression model followed by receiver operating characteristic (ROC) curve for diagnostic sensitivity. Significance was set at P < .05.ResultsPatients with A-CGCG (n = 36) were younger than those with nA-CGCG (n = 31) (P = .002). Logistic regression showed that CD163-GC (β = - .870, P = .031) and CD115-MC (β = - .783, P = .027) had a significant protection effect (OR = .419, 95% CI.190 thru .925, and OR = .457, 95% CI .229 thru .913, respectively). ROC curve analysis showed that CD163-GC and CSF-1R/CD115-MC combined were the best predictor in distinguishing nA-CGCG from A-CGCG (area under ROC, 0.814; P < .001). At the optimal cutoff value (0.408), sensitivity was 87% and specificity 65%.ConclusionIncreasing age and high expression of CD163-GC and CSF-1R/CD115-MC can serve as significant predictors of nA-CGCG. A functional link between CD163-GC and the characteristic areas of extravasation of erythrocyte is discussed.



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