title: Evaluation of SOX2 as a potential marker for ameloblastic carcinoma.
abstract: OBJECTIVE
  Ameloblastic carcinoma often poses diagnostic challenges in its separation from benign ameloblastoma with atypical cytologic features or an unusual clinical course. This study aimed to determine whether SOX2 (sex determining region-Y-related high mobility group box 2), a protein expressed in the epithelial basal proliferative zone in dentigerous cysts, is a marker for ameloblastic carcinoma as well as for high-grade transformation in ameloblastic neoplasms.
  
  
  METHODS
  Immunoperoxidase stains were performed according to a standard protocol. Immunostains were interpreted independently by 3 pathologists, and scores were recorded based on the percentage of staining and intensity of staining in the cells of interest.
  
  
  RESULTS
  The diffuse strong nuclear staining pattern has 86.4% specificity (19 of 22) to indicate the presence of high-grade features and has 76.9% sensitivity (10 of 13) in comparison with benign counterparts (P = .0021). Although previously shown as a marker for ameloblastic neoplasms, calretinin is weakly positive in a few cells in 50% (5 of 10) of ameloblastic carcinoma and 43% (3 of 7) of benign ameloblastic neoplasms, with little value in highlighting the high-grade change (P = .36).
  
  
  CONCLUSIONS
  The diffuse nuclear staining pattern of SOX2 is suggestive of a high-grade process in ameloblastic neoplasms. Numerous aggregates of cells harboring dense nuclear stain should raise concern for a malignancy.
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA. Electronic address: leiy@upmc.edu.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lei
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
authors.forename: Jumana M
authors.initials: JM
authors.lastname: Jaradat
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
authors.forename: Adepitan
authors.initials: A
authors.lastname: Owosho
authors.affiliation: Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Kehinde E
authors.initials: KE
authors.lastname: Adebiyi
authors.affiliation: Division of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Kelley S
authors.initials: KS
authors.lastname: Lybrand
authors.affiliation: Division of Oral Pathology, Department of Stomatology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Brad W
authors.initials: BW
authors.lastname: Neville
authors.affiliation: Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Müller
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bilodeau
mesh_terms: D000564:Ameloblastoma / Q000378:metabolism* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D007573:Jaw Neoplasms / Q000378:metabolism* / Q000473:pathology; D008856:Microscopy, Fluorescence; D055748:SOXB1 Transcription Factors / Q000378:metabolism*; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; C527782:SOX2 protein, human; D055748:SOXB1 Transcription Factors