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법랑아세포종에서 apoptosis 연관 인자 발현과 apoptitic index
목동진,박진배,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4
Objective : Ameloblastoma is a common odontogenic benign tumor of the jaw bone. However, it might be able to infiltrate into the adjacent tissue, causing bony destruction and high recurrent rate. The aim of this study is to understand the biologic behavior of ameloblastoma through immunohistochemi cal stainings for apoptosis-related markers of bcl-2, box and caspase-3, examining the apoptosis index and simultanecusly. performing the same tests on MIB-1, which is a marker of cell-proliferationg capacity and p53, which is related with tumor malignancy, and also study the differences between the above marker's expressions and their relationships. Methods and Material : The 39 cases of ameloblastoma were used after the surgery conducted at the Pusan Back Hospital and the Pusan University Hospital during the period from January 1991 to June 2001. The clinical parameters were recorded by patent's age, sex, location of tumor, treatment modality, radiologic findings and recurrences. Based on hematoxylin & eosin findings, they were histologicaly subdivided into follicular and non-follicular. Immunohistochemical stainings for bcl-2, bax, caspase-3. p53 and MIB-1 and TdT-mediated dUTP-biotin nick end labelling method for apoptosis were performed and also statistical analyses were conducted between clinicopathologic parameters and expressions for bcl-2, bax, caspase-3, p53 and MIB-1 and apoptosis. Results : six(15.4%) recurrences were found out of 39 cases. For the patient's age of 40 and above, found a higher recurrence rate(p=0.0182) and multilocular on X-ray(p=0.0640), but there were no significant differences between recurrence rate, sex, location of tumor, treatment modality and histologic subtype. Apoptosis was found in 10(25.6%) of 39 cases and bcl-2 was(20.5%), bax was 21(53.8%), caspase-3 was 19(48.7%). the positive reaction for p53 was 13 cases(33.3%) and 5(12.8) cases for MIB-1. In the positive case of apoptosis and MIB=1, both of them have showed an increasing tendency of high recurrence, but there were no statistical significance. It showed no significant relationship between expression rates of bcl-2, bax, caspase-3 and p53 and recurrence rate. In follicular type, bcl-2 and p53 positive reaction revealed increasing tendency, however, no significant relationship between radiological finding, expressions of apoptosis, bax, caspase-3 and MIB-1 and histologic subtype has found. No significant relationship between apoptosis and apoptosis-related markers as bcl-2, bax, and caspase-3 expressions has found. There was a significant relationship between bcl-2 and p53 expressions(p<0.01), but no significant differences of apoptosis and expressions of bax and caspase-3 according to p53 and MIB-1 expressions have noted. Conclusion : Apoptosis-related bcl-2, bax, caspase-3 expressions and p53 and MIB-1 expressions are involved in the development of ameloblastoma and high recurrent rate is related to the age of more than 40 years, multichambered lesion and the positive reaction for apoptosis and MIB-1. These finding suggest that patient's age, radiologic findings, apoptosis and proliferation activity of ameloblastoma could be useful markers to predict recurrence.
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