A Comparative immunohistochemical analysis of epithelial-mesenchymal transition biomarkers in odontogenic keratocyst, dentigerous cyst, and radicular cyst.

Abstract

Background: Odontogenic keratocyst (OKC) is one of the common odontogenic cysts with aggressive clinical behavior and a high recurrence rate. Epithelial-mesenchymal transition (EMT) is a process, in which the epithelial cell loses its epithelial characteristics and acquires mesenchymal features. Since the evidence for the involvement of EMT in the development of OKC is still limited, the present study aimed to investigate the immunohistochemical expression of EMT-related proteins (E-cadherin and N-cadherin) in OKC and compare them to radicular cyst (RC) and dentigerous cyst (DC).

Materials and methods: In this descriptive analytical study, 75 paraffin blocks, including 25 DCs, 25 OKC, and 25 RCs, were selected. Immunohistochemical staining was performed to determine the expression and staining intensity of E-cadherin and N-cadherin proteins. The specimens were examined under an optical microscope, and the data were analyzed using the Kruskal-Wallis test in SPSS statistical software (version 23) with a significance level of 5%.

Results: The expression of N-cadherin in OKC was higher than that in other cysts; nonetheless, there was no statistically significant difference (P = 0.331). The staining intensity of N-cadherin was weak in most cases, and this difference was not statistically significant (P = 0.252). E-cadherin expression in OKC was significantly lower than that in radicular and DCs (P = 0.003). In addition, the staining intensity of E-cadherin in OKC was weak and moderate (P = 0.003).

Conclusion: In this study, we observed an increase in the expression of N-cadherin in OKC. In addition, the protein expression levels of E-cadherin in OKC were significantly lower compared to DC and RC. Therefore, it appears that the EMT process likely occurs in OKC and may contribute to its local aggressive behavior.