Evaluation of the Biological Behaviour of Odontogenic Keratocysts Compared with Ameloblastoma and Radicular Cysts Using Cyclin-Dependent Kinase 1 Biomarker

Abstract

The odontogenic keratocyst (OKC) is classified as a cyst in the 2022 World Health Organisation classification, despite its aggressive behaviour and high recurrence rate. This study aimed to evaluate the expression of cyclin-dependent kinase-1 (CDK1) in odontogenic keratocysts, radicular cysts (RC), and ameloblastoma (AM), and to correlate it with the established behaviour of these lesions. In this retrospective study, we analysed eighty-eight archived formalin-fixed, paraffin-embedded cases: thirty-four odontogenic keratocysts, twenty-nine radicular cysts, and twenty-five ameloblastomas. We performed routine IHC staining to evaluate and compare CDK1 expression across these three types of lesions. The results showed that CDK1 expression was significantly higher in the suprabasal layers of odontogenic keratocysts compared with radicular cysts, with low immunoreactivity (P < 0.001). Also, there was no significant statistical difference between the staining intensity of follicular and plexiform histological types of ameloblastoma (p-value=0.94). The results of this study reveal that CDK1 exhibits increased staining intensity in odontogenic keratocysts compared to AM and RC. This likely explains why these cysts tend to be more aggressive and grow faster. In contrast, the reactivity of CDK1 was negligible in the lining of radicular cysts, whereas it was prominent in the stromal inflammatory cells of these cysts. This observation appears more associated with inflammation than with actual neoplastic development. Samples from AM suggest that the difference in staining patterns between follicular and plexiform types may indicate changes in tumour architecture and growth dynamics.