Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Ca...Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Carnoy’s solution or Cryosurgery. Currently, there is no consensus concerning the therapeutic choice for the KCOT. The purpose of this study was to evaluate the different treatment methods used for the management of KCOT in the Second Affiliated Hospital of Jiamusi University and the results obtained from those treatment methods. Settings and Design: Clinical study was done at the Second Affiliated Hospital of Jiamusi University. Materials and Methods: Analytical retrospective review of 63 cases treated surgically from 2009 to 2015 at the Maxillofacial and Oral Surgery Department of the Second Affiliated Hospital of Jiamusi University. All cases diagnosed as KCOT and registered in the archives were used. The level of statistical significance was set at P < 0.05. Results: Of the 63 cases, 55.56% were male and 44.44% female. The sex ratio was 1.25 in favor of male and the average age was 42 years. 81% of the lesions were located in the mandible. Of 40 cases treated by enucleation with peripheral ostectomy, curettage and electric cauterization with application of 2% iodine tincture, no recurrence was found. Of 20 cases treated by the same surgical method but without the application of 2% iodine tincture, recurrence was found in 3 cases (4.76%). 3 cases treated by resection had no recurrence. Significant relation between recurrence and type of treatment was found (P < 0.05). Conclusion: In our series, those cases that were treated by combination of surgical methods used with 2% iodine tincture showed an “improvement” in the reduction of recurrence, suggesting a future question to be examined in experimental study is to test the effectiveness of 2% iodine tincture.展开更多
Keratocystic odontogenic tumors （KCOT） are benign, locally aggressive intraosseous tumors of odontogenic origin. KCOT have a higher stromal microvessel density （MVD） than dentigerous cysts （DC） and normal oral m...Keratocystic odontogenic tumors （KCOT） are benign, locally aggressive intraosseous tumors of odontogenic origin. KCOT have a higher stromal microvessel density （MVD） than dentigerous cysts （DC） and normal oral mucosa. To identify genes in the stroma of KCOT involved in tumor development and progression, RNA sequencing （RNA-Seq） was performed using samples from KCOT and primary stromal fibroblasts isolated from gingival tissues. Seven candidate genes that possess a function potentially related to KCOT progression were selected and their expression levels were confirmed by quantitative PCR, immunohistochemistry and enzyme-linked immunosorbent assay. Expression of lysyl oxidase-like 4 （LOXL4）, the only candidate gene that encodes a secreted protein, was enhanced at both the mRNA and protein levels in KCOT stromal tissues and primary KCOT stromal fibroblasts compared to control tissues and primary fibroblasts （P〈0.05）. In vitro, high expression of LOXL4 could enhance proliferation and migration of the human umbilical vein endothelial cells （HUVECs）. There was a significant, positive correlation between LOXL4 protein expression and MVD in stroma of KCOT and control tissues （r=0.882）. These data suggest that abnormal expression of LOXL4 of KCOT may enhance angiogenesis in KCOT, which may help to promote the locally aggressive biological behavior of KCOT.展开更多
Aim To clarify the role of PTCH in patients with NBCCS- related and non-sydromic keratocystic odontogenic tumors. Methodology Mutation analysis was undertaken in 8 sporadic and 4 NBCCS-associated KCOTs. Results Four n...Aim To clarify the role of PTCH in patients with NBCCS- related and non-sydromic keratocystic odontogenic tumors. Methodology Mutation analysis was undertaken in 8 sporadic and 4 NBCCS-associated KCOTs. Results Four novel and two known mutations were identifled in 2 sporadic and 3 syndromic cases, two of which being germline mutations （c.2179delT, c.2824delC） and 4 somatic mutations （c.3162dupG, c.1362-1374dup, c.1012 C〉T, c.403C〉T）. Conclusion Our findings suggest that defects of PTCH are associated with the pathogenesis of syndromic as well as a subset of non-syndromic KCOTs.展开更多
BACKGROUND In rare cases,odontogenic keratocysts(ODs)transform into squamous cell carcinoma.Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to ...BACKGROUND In rare cases,odontogenic keratocysts(ODs)transform into squamous cell carcinoma.Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years.In this article,we report a case of malignancy derived from OD with a five-day delay in diagnosis.CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan,China with complaints of moderate pain,recurrent swelling,and pus discharge around her left maxillary lateral incisor for over 10 years.Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck.Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar.The patient was clinically diagnosed with OD.Enucleation rather than marsupialization was performed given the risk factors of long history,recent aggravated pain,and massive bony destruction.Malignant transformation of OD was confirmed by pathologists 3 d after the operation.Radical surgery was performed,and lymph node metastasis was observed.The patient was subjected to postoperative radiotherapy and synchronous chemotherapy,and no local recurrence or distant metastasis was noted at one-year follow-up.CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD,especially when patients present with a long history,massive cyst,chronic inflammation,recent persistent infections,aggravated pain,numbness around the cystic lesion,and lymph node enlargement.展开更多
First described by Philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. It is now designated by the World Hea...First described by Philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. It is now designated by the World Health Organization as a keratocystic odontogenic tumour (KOT). Clinically, the KOT is manifested by an asymptomatic growth. Radiographically, it appears as a well-defined uni-locular or multilocular osteolytic lesion. The diagnostic approach is based on a combined analysis of the medical history, the clinical appearance and the radiographic appearance. The diagnosis may be confirmed by the anatomical pathology report. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. The authors report a case of keratocystic odontogenic tumor of the upper jaw and review the various diagnoses, therapeutics and follow up aspects of this type of tumors.展开更多
文摘Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Carnoy’s solution or Cryosurgery. Currently, there is no consensus concerning the therapeutic choice for the KCOT. The purpose of this study was to evaluate the different treatment methods used for the management of KCOT in the Second Affiliated Hospital of Jiamusi University and the results obtained from those treatment methods. Settings and Design: Clinical study was done at the Second Affiliated Hospital of Jiamusi University. Materials and Methods: Analytical retrospective review of 63 cases treated surgically from 2009 to 2015 at the Maxillofacial and Oral Surgery Department of the Second Affiliated Hospital of Jiamusi University. All cases diagnosed as KCOT and registered in the archives were used. The level of statistical significance was set at P < 0.05. Results: Of the 63 cases, 55.56% were male and 44.44% female. The sex ratio was 1.25 in favor of male and the average age was 42 years. 81% of the lesions were located in the mandible. Of 40 cases treated by enucleation with peripheral ostectomy, curettage and electric cauterization with application of 2% iodine tincture, no recurrence was found. Of 20 cases treated by the same surgical method but without the application of 2% iodine tincture, recurrence was found in 3 cases (4.76%). 3 cases treated by resection had no recurrence. Significant relation between recurrence and type of treatment was found (P < 0.05). Conclusion: In our series, those cases that were treated by combination of surgical methods used with 2% iodine tincture showed an “improvement” in the reduction of recurrence, suggesting a future question to be examined in experimental study is to test the effectiveness of 2% iodine tincture.
基金supported by the National Natural Science Foundation of China (grant nos. 81030018, 30872900 and 30901680)the Doctoral Fund of Ministry of Education of China (grant no. 20120001110043)
文摘Keratocystic odontogenic tumors （KCOT） are benign, locally aggressive intraosseous tumors of odontogenic origin. KCOT have a higher stromal microvessel density （MVD） than dentigerous cysts （DC） and normal oral mucosa. To identify genes in the stroma of KCOT involved in tumor development and progression, RNA sequencing （RNA-Seq） was performed using samples from KCOT and primary stromal fibroblasts isolated from gingival tissues. Seven candidate genes that possess a function potentially related to KCOT progression were selected and their expression levels were confirmed by quantitative PCR, immunohistochemistry and enzyme-linked immunosorbent assay. Expression of lysyl oxidase-like 4 （LOXL4）, the only candidate gene that encodes a secreted protein, was enhanced at both the mRNA and protein levels in KCOT stromal tissues and primary KCOT stromal fibroblasts compared to control tissues and primary fibroblasts （P〈0.05）. In vitro, high expression of LOXL4 could enhance proliferation and migration of the human umbilical vein endothelial cells （HUVECs）. There was a significant, positive correlation between LOXL4 protein expression and MVD in stroma of KCOT and control tissues （r=0.882）. These data suggest that abnormal expression of LOXL4 of KCOT may enhance angiogenesis in KCOT, which may help to promote the locally aggressive biological behavior of KCOT.
基金supported by Research Grants from the National Nature Science Foundation of China(30625044,30572048 and 30872900)Specialized Research Fund for the Doctoral Program of Higher Education(20050001110)
文摘Aim To clarify the role of PTCH in patients with NBCCS- related and non-sydromic keratocystic odontogenic tumors. Methodology Mutation analysis was undertaken in 8 sporadic and 4 NBCCS-associated KCOTs. Results Four novel and two known mutations were identifled in 2 sporadic and 3 syndromic cases, two of which being germline mutations （c.2179delT, c.2824delC） and 4 somatic mutations （c.3162dupG, c.1362-1374dup, c.1012 C〉T, c.403C〉T）. Conclusion Our findings suggest that defects of PTCH are associated with the pathogenesis of syndromic as well as a subset of non-syndromic KCOTs.
基金Supported by the National Natural Science Foundation of China,No.81600911.
文摘BACKGROUND In rare cases,odontogenic keratocysts(ODs)transform into squamous cell carcinoma.Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years.In this article,we report a case of malignancy derived from OD with a five-day delay in diagnosis.CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan,China with complaints of moderate pain,recurrent swelling,and pus discharge around her left maxillary lateral incisor for over 10 years.Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck.Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar.The patient was clinically diagnosed with OD.Enucleation rather than marsupialization was performed given the risk factors of long history,recent aggravated pain,and massive bony destruction.Malignant transformation of OD was confirmed by pathologists 3 d after the operation.Radical surgery was performed,and lymph node metastasis was observed.The patient was subjected to postoperative radiotherapy and synchronous chemotherapy,and no local recurrence or distant metastasis was noted at one-year follow-up.CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD,especially when patients present with a long history,massive cyst,chronic inflammation,recent persistent infections,aggravated pain,numbness around the cystic lesion,and lymph node enlargement.
文摘First described by Philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. It is now designated by the World Health Organization as a keratocystic odontogenic tumour (KOT). Clinically, the KOT is manifested by an asymptomatic growth. Radiographically, it appears as a well-defined uni-locular or multilocular osteolytic lesion. The diagnostic approach is based on a combined analysis of the medical history, the clinical appearance and the radiographic appearance. The diagnosis may be confirmed by the anatomical pathology report. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. The authors report a case of keratocystic odontogenic tumor of the upper jaw and review the various diagnoses, therapeutics and follow up aspects of this type of tumors.
