Marcadores biológicos em ameloblastoma: uma revisão de literatura.

Abstract

Ameloblastoma (AM) is a benign neoplasm of the odontogenic epithelium that develops from the remnants of the dental blade and the enamel organ. They are lesions that preferentially affect the posterior region of the mandible, being locally invasive, with a slow and infiltrative growth pattern, presenting a high rate of recurrence. Because of a pathogenesis that has not yet been fully elucidated, AM is the subject of several researches in order to better understand the behavior of this lesion. Thus, the objective of this work is to perform a literature review of the main biomarkers involved in the pathogenesis and development of AM and to associate them with diagnostic and prognostic factors. For this, a bibliographic survey of the last 10 years was carried out in the PubMed (Pubmed Central®) databases, using the following English descriptors: "Ameloblastoma", "Pathogenesis" and "Biomarkers". The inclusion criteria used in the search were: laboratory studies (immunohistochemical and molecular) and English-language studies from 2008 to 2018, while the exclusion criteria used were: literature reviews, clinical case reports, animal studies and studies not related to the theme. Following the inclusion and exclusion criteria, 44 articles were selected. The studies totaled 1.725 AM cases, of which 1.149 were in the mandible, 139 in the maxilla and 10 in other locations, according to the articles that provided clinical data. The main biomarkers found were: BRAF, KI67, MCMs, FGFs and MMPs. Mutations in the BRAF gene (BRAFV600E) were associated with more aggressive tumor pictures. Ki67 and MCMs were well-used markers for AM, being associated with cell proliferation and tumor growth. High FGFs were observed in recurrence frames, and MMPs are associated with tumor invasiveness. Thus, the study of these markers in aggressive lesions is necessary to better understand the pathogenesis of AM, as well as to direct the development of more adequate therapies and a better prognosis to the patient.