title: Cytokeratin 13, Cytokeratin 17, and Ki-67 Expression in Human Acquired Cholesteatoma and Their Correlation With Its Destructive Capacity.
abstract: OBJECTIVE
  Cholesteatoma is a nonneoplastic destructive lesion of the temporal bone with debated pathogenesis and bone resorptive mechanism. Both molecular and cellular events chiefly master its activity. Continued research is necessary to clarify factors related to its aggressiveness. We aimed to investigate the expression of Ki-67, cytokeratin 13 (CK13) and cytokeratin 17 (CK17) in acquired nonrecurrent human cholesteatoma and correlate them with its bone destructive capacity.
  
  
  METHODS
  A prospective quantitative immunohistochemical study was carried out using fresh acquired cholesteatoma tissues (n=19), collected during cholesteatoma surgery. Deep meatal skin tissues from the same patients were used as control (n=8). Cholesteatoma patients were divided into 2 groups and compared (invasive and noninvasive) according to a grading score for bone resorption based upon clinical, radiologic and intraoperative findings. To our knowledge, the role of CK17 in cholesteatoma aggressiveness was first investigated in this paper.
  
  
  RESULTS
  Both Ki-67 and CK17 were significantly overexpressed in cholesteatoma than control tissues (P<0.001 for both Ki-67 and CK17). In addition, Ki-67 and CK17 were significantly higher in the invasive group than noninvasive group of cholesteatoma (P=0.029,P=0.033, respectively). Furthermore, Ki-67 and CK17 showed a moderate positive correlation with bone erosion scores (r=0.547,P=0.015 andr=0.588,P=0.008, respectively). In terms of CK13, no significant difference was found between cholesteatoma and skin (P=0.766).
  
  
  CONCLUSIONS
  Both Ki-67 and CK17 were overexpressed in cholesteatoma tissue and positively correlated with bone resorption activity. The concept that Ki-67 can be a predictor for aggressiveness of cholesteatoma was supported. In addition, this is the first study demonstrating CK17 as a favoring marker in the aggressiveness of acquired cholesteatoma.
authors.affiliation: Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.|Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Mahmood A
authors.initials: MA
authors.lastname: Hamed
authors.affiliation: Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nakata
authors.affiliation: Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Shiogama
authors.affiliation: Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.|Department of Otorhinolaryngology, Yonaha General Hospital, Kuwana, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Ramadan H
authors.initials: RH
authors.lastname: Sayed
authors.affiliation: Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nishimura
authors.affiliation: Department of Otorhinolaryngology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Iwata
authors.affiliation: Department of Pathology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Sakurai
authors.affiliation: Department of Otorhinolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Badawy S
authors.initials: BS
authors.lastname: Badawy
authors.affiliation: Department of Pathology, Banbuntane-Hotokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Inada
authors.affiliation: Department of Otorhinolaryngology, Red Cross Nagoya Daiichi Hospital, Nagoya, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Tsuge
authors.affiliation: Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsutsumi
keywords: Bone Resorption; Cholesteatoma; Cytokeratin 17; Ki-67 Antigen; Middle Ear