Marsupialisation or decompression is frequently performed as a conservative therapy for keratocystic odontogenic tumours (KCOTs). Positive cyclooxygenase-2 (COX-2) expression in the epithelium of KCOTs was recently reported and may be associated with neoplastic invasion and progression. The aim of the present study was to investigate the change in COX-2 expression in the KCOT epithelium following decompression. In this study, 16 pairs of KCOT biopsy specimens obtained during decompression or enucleation were collected and analysed. Formalin-fixed, paraffin-embedded blocks were sectioned and immunohistochemically investigated using anti-COX-2 antibody. The molecular expression was semi-quantitatively evaluated as follows: 0, negative; 1, weakly to moderately positive; and 2, strongly positive. In the samples obtained prior to decompression, the positive staining for COX-2 was immunolocalised to the cell membrane and the cytoplasm, it involved the full thickness of the epithelium and 15 of the 16 specimens (93.8%) exhibited mild to strong positivity. As regards the samples obtained following decompression, only 3 of the 16 specimens (18.8%) exhibited a mild positivity. The expression levels of COX-2 were significantly decreased following decompression (P<0.05). It may be concluded that loss or a significant reduction of COX-2 expression is associated with decompression in KCOTs. However, large-scale studies are required to verify these results and improve our knowledge of the possible involvement of COX-2 in the pathogenic mechanism underlying the development of KCOTs.
Keywords: cyclooxygenase-2; decompression; immunohistochemistry; keratocystic odontogenic tumour.