Özge KAYA KORKMAZ, Havva ERDEM, Mürüvvet AKÇAY ÇELİK, Fadime Gül SALMAN, Büşra ERŞAN ERDEM, Yeliz KAŞKO ARICI

Odontojenik Kistlerde Plazma Hücresi ve Makrofajların Dağılımı

Özet Amaç : Odontojenik kistler maksillofasiyal bölgenin sık karşılaşılan önemli lezyonlarıdır. Radiküler kistler, dentijeröz kistler ve odontojenik keratokistler en sık karşılaşılan odontojenik kistlerdir. Makrofajlar ve plasma hücreleri inflamasyonun temel hücreleridir ve bir çok hastalığın oluşumunda rol oynarlar. Bu çalışmanın amacı; en sık karşılaşılan odontojenik kistlerde makrofaj ve plazma hücrelerinin varlığını ve dağılımını klinik bilgilerle birlikte karşılaştırmak amaçlanmıştır. Metod: Çalışmamıza laboratuvarımızda Ocak 2013 ile Aralık 2022 tarihleri arasında odontojenik kist tanısı almış, eksizyonel biyopsi uygulanmış olgular dahil edildi. Olgulara ait Hematoksilen-Eozin boyalı kesitler değerlendirildi. İmmünhistokimyasal (İHK) boyama için en uygun olan alanlar işaretlendi. Daha sonra parafin bloklardan 2 mm çapta silindirik şekilli parafinize doku örnekleri manuel mikroarray cihazı ile donör bloklardan alınarak çoklu bloklara aktarıldı. Anti- CD68 ve anti- CD138 immünhistokimyasal boyası çoklu bloklara uygulandı. Boyalı preparatlar ortalama bir skor verilerek 0-2 arasında puanlandı. Daha sonra verilen skorlar 3 grup arasında klinik verilerle birlikte analiz edildi. Bulgular: Çalışmamıza dahil edilen 83 odontojenik kistin 41 tanesi radiküler kist, 25 tanesi dentijeröz kist ve 17 tanesi keratokistti. Hastaların yaşları 17 ile 77 arasında değişiyordu ve ortalama 37,55± 16,42’ idi. Hastaların %47’si erkek iken % 53 kadındı. Radiküler kist, dentijeröz kist ve keratokist grupları arasında yaş ve cinsiyet açısından anlamlı fark yoktu (p>0.05). Kist tipi ile CD68+ makrofajların ve CD138+ plasma hücrelerinin oranları arasında anlamlı fark saptandı. (p<0.05). Sonuç : Odontojenik kist tipleri arasında CD68+ makrofajların ve CD138 + plasma hücrelerinin dağılımında anlamlı fark saptanmıştır.Bu nedenle odontojenik kistlerin histomorfolojik özellikleri hakkında daha fazla bilgi sahip olmak ve inflamatuar süreçlerini anlamak doğru tanı ve tedavi için önem arz etmektedir.

Anahtar Kelimeler:

Radiküler kist, Odontojenik kist, Makrofaj, Plazma hücresi

Distribution of Macrophages and Plasma Cells in Odontogenic Cysts

Abstract Objective : Odontogenic cysts are common and important lesions of the maxillofacial region. Radicular cysts, dentigerous cysts, and odontogenic keratocysts are the most common odontogenic cysts. Macrophages and plasma cells are the main cells of inflammation and play a role in the development of many diseases. This study aimed to compare the presence and distribution of macrophages and plasma cells among the most common odontogenic cysts with clinical data. Method : Cases diagnosed with odontogenic cysts in our laboratory were included in our study. Hematoxylin-Eosin stained sections of the cases in the archive were re-evaluated. The area that best reflected the inflammation tissue was first marked on the slides and then on the blocks. Then, 2 mm diameter cylindrical-shaped paraffinized tissue samples were taken from donor blocks and transferred to multiple blocks with a manual microarray device. Anti-CD68 and anti-CD138 immunohistochemical stains were applied to multiple blocks. The stained preparations were scored between 0-2 by giving an average score. The scores were then analyzed together with clinical data between the three groups. Results: Of the 83 odontogenic cysts included in our study, 41 were radicular cysts, 25 were dentigerous cysts, and 17 were keratocysts. The ages of the patients ranged from 17 to 77 years, with a mean of 37.55± 16.42 years. 47% of the patients were male, and 53% were female. There was no significant difference between the odontogenic cyst groups regarding age and gender (p>0.05). There was a significant difference between the cyst type and the proportions of CD68+ macrophages and CD138+ plasma cells (p<0.05). Conclusion: There was a significant difference in the distribution of CD68+ macrophages and CD138+ plasma cells in odontogenic cyst type. Therefore, it is important to have more information about the histomorphologic features of odontogenic cysts and to understand their inflammatory processes for correct diagnosis and treatment.

Keywords:

Radicular cyst, odontogenic cyst, macrophage, plasma cells.,

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1. Wang LL, Olmo H. Odontogenic Cysts. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK574529/
2. Sharifian MJ, Khalili M. Odontogenic cysts:a retrospective study of 1227 cases in an Iranian population from 1987 to 2007. J Oral Sci 2011;53(3):361–7. https://doi.org/10.2334/josnusd.53.361
3. Pekiner FN, Borahan O, Uğurlu F, Horasan S, Şener BC, Olgac V. Clinical and radiological features of a large radicular cyst involving the entire maxillary sinus. J Marmara University Institute Health Sci 2012;2:31-6.
4. Santos LC, Vilas Bôas DS, Oliveira GQ, Ramos EA, Gurgel CA, Dos Santos JN. Histopathological study of radicular cysts diagnosed in a Brazilian population. Brazilian Dent J 2011;22(6):449–54. https://doi.org/10.1590/s0103-64402011000600002
5. Regezi JA. Odontogenic cysts, odontogenic tumors, fibroosseous, and giant cell lesions of the jaws. Modern Pathol 2002;15(3):331–41. https://doi.org/10.1038/modpathol.3880527
6. Alcantara BA, Carli ML, Beijo LA, Pereira AA, Hanemann JA. Correlation between inflammatory infiltrate and epithelial lining in 214 cases of periapical cysts. Brazilian Oral Res 2013;27(6):490–5. https://doi. org/10.1590/S1806-83242013005000023
7. Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology: Clinical Pathologic Correlations. 7th Edition, St Louis: Saunders Elsevier;2017. P.245-88.
8. França GM, Carmo AFD, Costa Neto H, Andrade ALDL, Lima KC, Galvão HC. Macrophages subpopulations in chronic periapical lesions according to clinical and morphological aspects. Brazilian Oral Res 2019;33:e047. https://doi.org/10.1590/1807-3107bor-2019.vol33.0047
9. Takahashi K., MacDonald DG, Kinane DF. Analysis of immunoglobulin synthesizing cells in human dental periapical lesions by in situ hybridization and immunohistochemistry. J Oral Pathol Med 2016;25(6):331–5. https://doi.org/10.1111/j.1600-0714.1996.tb00272.x
10. Takahashi K, Lappin DF, MacDonald GD, Kinane DF. Relative distribution of plasma cells expressing immunoglobulin G subclass mRNA in human dental periapical lesions using in situ hybridization. J Endodontics 1998;24(3):164–7. https://doi.org/10.1016/S0099-2399(98)80175-1
11. Bracks IV, Armada L, Gonçalves LS, Pires FR. Distribution of mast cells and macrophages and expression of interleukin-6 in periapical cysts. J Endodontics 2014;40(1):63–8. https://doi.org/10.1016/j.joen.2013.09.037
12. Azeredo SV, Brasil SC, Antunes H, Marques F V, Pires FR, Armada L. Distribution of macrophages and plasma cells in apical periodontitis and their relationship with clinical and image data. J Clin Exp Dent 2017;9(9):1060–5. https://doi.org/10.4317/jced.53758
13. Gazivoda D, Dzopalic T, Bozic B, Tatomirovic Z, Brkic Z, Colic M. Production of proinflammatory and immunoregulatory cytokines by inflammatory cells from periapical lesions in culture. J Oral Pathol Med 2009;38(7):605–11. https://doi.org/10.1111/j.1600-0714.2009.00788.x
14. Kouhsoltani M, Abdolhosseinzadeh M, Bahramian A, Vakili Saatloo M, Dabbaghi Tabriz F, Pourlak T. A Comparative Study of Macrophage Density in Odontogenic Cysts and Tumors with Diverse Clinical Behavior. J Dent 2018;19(2):150–4.
15. Song Y, Li X, Huang D, Song H. Macrophages in periapical lesions:Potential roles and future directions. Front Immunol 2022;13:949102. https://doi.org/10.3389/fimmu.2022.949102
16. Weber M, Schlittenbauer T, Moebius P, Büttner-Herold M, Ries J, Preidl R, Geppert CI, Neukam FW, Wehrhan F. Macrophage polarization differs between apical granulomas, radicular cysts, and dentigerous cysts. Clin Oral Invest 2018;22(1):385–94. https://doi.org/10.1007/s00784-017-2123-1
17. Nair PN. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med 2004;15(6):348–81. doi:10.1177/154411130401500604
18. Becconsall-Ryan K, Tong D, Love RM. Radiolucent inflammatory jaw lesions:a twenty-year analysis. Int Endod J 2010;43(10):859–65. https://doi.org/10.1111/j.1365-2591.2010.01751.x
19. Marçal JR, Samuel RO, Fernandes D, et al. T-helper cell type 17/regulatory T-cell immunoregulatory balance in human radicular cysts and periapical granulomas. J Endod 2010;36(6):995–9. https://doi.org/10.1016/j.joen.2010.03.020