牙源性钙化囊肿组织病理及细胞增殖活性的研究

A study of histopathology and cell proliferation in calcifying odontogenic cyst

目的研究牙源性钙化囊肿（ｃａｌｃｉｆｙｉｎｇｏｄｏｎｔｏｇｅｎｉｃｃｙｓｔ，ＣＯＣ）的组织病理、临床特征及其细胞增殖活性。方法对２５例ＣＯＣ的标本进行ＨＥ染色和组织学观察，增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ，ＰＣＮＡ）采用免疫组织化学法（ＡＢＣ法）和银染核仁形成区（ａｒｇｙｒｏｐｈｉｌｓｔａｉｎｉｎｇｎｕｃｌｅｏｌａｒｏｒｇａｎｉｚｅｒｒｅｇｉｏｎ，ＡｇＮＯＲ）计数。结果２５例ＣＯＣ中，１３例为囊肿型，８例为良性肿瘤型，４例为恶性型，即牙源性影细胞癌。不同类型的ＣＯＣ中，细胞增殖活性不同。牙源性影细胞癌内ＰＣＮＡ的阳性表达率和ＡｇＮＯＲ均数都显著高于其他类型的ＣＯＣ（Ｐ＜０．０１）。结论ＣＯＣ在结构和生物学行为上均具有较大的变异性。

Objective To investigate the histopathologic and clinical characteristics and proliferative activities of calcifying odontogenic cyst (COC). Methods 25 cases of COC were reviewed. The expression of proliferating cell nuclear antigen (PCNA) was studied using avidinbiotin peroxidase method and the number of nuclear organizing regions was calculated by means of the argyrophil staining technique in these cases. Results The cases were divided into 13 (52%) cysts and 12 (48%) neoplasms. Of the 12 neoplasms, 4 were odontogenic ghost cell carcinoma, with a PCNA labelling index (65.9%±7.3%) significantly higher than that of benign neoplastic variant (45.8%±11.5%, P<0.05) and cystic variant (29.3%±11.2%, P<0.01). The AgNOR counts was higher in the carcinomatous than benign or cystic variant. Conclusion The lesions show considerable diversity in structure and behavior. It is therefore proposed that quantiation of staining for NORassociated proteins and the PCNA labelling index are diagnostically useful in COC.