title: Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation.
abstract: BACKGROUND
  The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico-pathologic and immunohistochemical findings.
  
  
  METHODS
  Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki-67 and p53.
  
  
  RESULTS
  Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow-up period (median: 33 months, range: 7-114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki-67 (LI >10%) in basal layer and four (4/28; 14.3%) among non-recurrence group (P = 0.025). Expression of p53 among non-recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group (P = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42-18.14) for high Ki-67 expression in the basal layer by the Cox proportional hazard model (P = 0.009). In our study, none of the other clinico-pathologic variables were associated with the recurrence of KCOT.
  
  
  CONCLUSIONS
  The results suggested that the evaluation of Ki-67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.
authors.affiliation: Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Aichi, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kuroyanagi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sakuma
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyabe
authors.forename: Junichiro
authors.initials: J
authors.lastname: Machida
authors.forename: Atsuo
authors.initials: A
authors.lastname: Kaetsu
authors.forename: Motoo
authors.initials: M
authors.lastname: Yokoi
authors.forename: Hatsuhiko
authors.initials: H
authors.lastname: Maeda
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
authors.forename: Toru
authors.initials: T
authors.lastname: Nagao
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimozato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins; D019394:Ki-67 Antigen / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009807:Odontogenic Cysts / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012008:Recurrence; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D007633:Keratins