Main Article Content

Authors

Immunohistochemistry have had a huge impact on oral and maxillofacial pathology diagnosis. As a method it determines distribution and amount of certain cellular molecules via specific antigen-antibody reaction. Whereas in most cases a definitive diagnosis is achieved based on detailed hematoxylin and eosin cytomorphological analysis, along with clinical and radiological features, some challenging and equivocal neoplasms need to be further assessed with immunohistochemistry. This article reviews immunohistochemistry technique fundamentals and its role and relevance in the diagnosis of common oral and maxillofacial lesions encountered in  daily practice.

Jairo Alberto Bustillo Rojas , Pontificia Universidad Javeriana, School of Dentistry, Department of Buccal System, Division of Pathology and Buccal Surgery, Bogotá, Colombia.

Pontificia Universidad Javeriana, School of Dentistry, Department of Buccal System, Division of Pathology and Buccal Surgery, Bogotá, Colombia.   

Guillermo Enrique Blanco Ballesteros, Universidad Estatal de Londrina, School of Dentistry, Department of Oral Medicine and Pediatric Dentistry, Division of Oral and Maxillofacial Radiology, Londrina, Brasil.

Universidad Estatal de Londrina, School of Dentistry, Department of Oral Medicine and Pediatric Dentistry, Division of Oral and Maxillofacial  Radiology, Londrina, Brasil.

Guerrero, J., Bustillo Rojas , J. A. ., & Blanco Ballesteros, G. E. (2023). Immunohistochemistry in oral and maxillofacial pathology: The role and rational use of antibodies in the diagnosis of surgical lesions. Revista Estomatología, 31(1). https://doi.org/10.25100/re.v31i1.12306 (Original work published February 17, 2023)

Jones K, Jordan RC. Patterns of second-opinion diagnosis in oral and maxillofacial pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jun;109(6):865-9. doi: 10.1016/j.tripleo.2009.12.023.

Jordan RC, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. Part II: immunohistochemical and immunofluorescent methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jan;93(1):56-74. doi: 10.1067/moe.2002.119567.

Bilodeau E, Alawi F, Costello BJ, Prasad JL. Molecular diagnostics for head and neck pathology. Oral Maxillofac Surg Clin North Am. 2010 Feb;22(1):183-94. doi: 10.1016/j.coms.2009.10.006.

Jaffer S, Bleiweiss IJ. Beyond hematoxylin and eosin--the role of immunohistochemistry in surgical pathology. Cancer Invest. 2004;22(3):445-65. doi: 10.1081/cnv-200034896.

Miettinen M. Immunohistochemistry in oral pathology: An Adjunct Tool in Tumor Typing. Oral and Maxillofacial Surgery Clinics of North America, Volume 6, Issue 3,1994,Pages 391-400. /doi.org/10.1016/S1042-3699(20)30761-5.

Ajura AJ, Sumairi I, Lau SH. The use of immunohistochemistry in an oral pathology laboratory. Malays J Pathol. 2007 Dec;29(2):101-5. PMID: 19108402.

Araújo ALD, Fonsêca JM, do Amaral-Silva GK, de Lima Morais TM, Mariz BALA, Fonseca FP, Lopes MA, Vargas PA, Santos-Silva AR, de Almeida OP. The Role of Immunohistochemistry for Primary Oral Diagnosis in a Brazilian Oral Pathology Service. Appl Immunohistochem Mol Morphol. 2021 Nov-Dec 01;29(10):781-790. doi: 10.1097/PAI.0000000000000960.

Jain N. Essentials Before Sending Biopsy Specimens: A Surgeon's Prespective and Pathologists Concern. J Maxillofac Oral Surg. 2011 Dec;10(4):361-4. doi: 10.1007/s12663-011-0234-9.

Torlakovic EE, Nielsen S, Francis G, Garratt J, Gilks B, Goldsmith JD, Hornick JL, Hyjek E, Ibrahim M, Miller K, Petcu E, Swanson PE, Zhou X, Taylor CR, Vyberg M. Standardization of positive controls in diagnostic immunohistochemistry: recommendations from the International Ad Hoc Expert Committee. Appl Immunohistochem Mol Morphol. 2015 Jan;23(1):1-18. doi: 10.1097/PAI.0000000000000163.

Hewitt SM, Baskin DG, Frevert CW, Stahl WL, Rosa-Molinar E. Controls for immunohistochemistry: the Histochemical Society's standards of practice for validation of immunohistochemical assays. J Histochem Cytochem. 2014 Oct;62(10):693-7. doi: 10.1369/0022155414545224. Epub 2014 Jul 14. PMID: 25023613; PMCID: PMC4212362.

Hunter KD, Speight PM. The diagnostic usefulness of immunohistochemistry for odontogenic lesions. Head Neck Pathol. 2014 Dec;8(4):392-9. doi: 10.1007/s12105-014-0582-0. Epub 2014 Nov 20. PMID: 25409846; PMCID: PMC4245415.

Robinson RA. Diagnosing the most common odontogenic cystic and osseous lesions of the jaws for the practicing pathologist. Mod Pathol. 2017 Jan;30(s1):S96-S103. doi: 10.1038/modpathol.2016.191. PMID: 28060370.

Bilodeau EA, Collins BM. Odontogenic Cysts and Neoplasms. Surg Pathol Clin. 2017 Mar;10(1):177-222. doi: 10.1016/j.path.2016.10.006. Epub 2016 Dec 29. PMID: 28153133.

Crivelini MM, Felipini RC, Miyahara GI, de Sousa SC. Expression of odontogenic ameloblast-associated protein, amelotin, ameloblastin, and amelogenin in odontogenic tumors: immunohistochemical analysis and pathogenetic considerations. J Oral Pathol Med. 2012 Mar;41(3):272-80. doi: 10.1111/j.1600-0714.2011.01079.x. Epub 2011 Sep 21. PMID: 21936873.

Rai HK, Pai SM, Dayakar A, Supriya H. Adenoid ameloblastoma with dentinoid: A rare hybrid variant. J Oral Maxillofac Pathol. 2017 May-Aug;21(2):319. doi: 10.4103/jomfp.JOMFP_53_15. PMID: 28932051; PMCID: PMC5596692.

Chen CY, Wu CW, Wang WC, Lin LM, Chen YK. Clear-cell variant of calcifying epithelial odontogenic tumor (Pindborg tumor) in the mandible. Int J Oral Sci. 2013 Jun;5(2):115-9. doi: 10.1038/ijos.2013.29. Epub 2013 May 24. PMID: 23703711; PMCID: PMC3707072.

Martínez-Martínez M, Mosqueda-Taylor A, Carlos-Bregni R, Pires FR, Delgado-Azanero W, Neves-Silva R, Aldape-Barrios B, Paes-de Almeida O. Comparative histological and immunohistochemical study of ameloblastomas and ameloblastic carcinomas. Med Oral Patol Oral Cir Bucal. 2017 May 1;22(3):e324-e332. doi: 10.4317/medoral.21901. PMID: 28390135; PMCID: PMC5432081.

Evangelou Z, Zarachi A, Dumollard JM, Peoc'h M, Komnos I, Kastanioudakis I, Karpathiou G. Maxillary Ameloblastoma: A Review With Clinical, Histological and Prognostic Data of a Rare Tumor. In Vivo. 2020 Sep-Oct;34(5):2249-2258. doi: 10.21873/invivo.12035. PMID: 32871747; PMCID: PMC7652510.

Yoon HJ, Hong SP, Lee JI, Lee SS, Hong SD. Ameloblastic carcinoma: an analysis of 6 cases with review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Dec;108(6):904-13. doi: 10.1016/j.tripleo.2009.06.045. Epub 2009 Oct 2. PMID: 19800270.

Yoon HJ, Jo BC, Shin WJ, Cho YA, Lee JI, Hong SP, Hong SD. Comparative immunohistochemical study of ameloblastoma and ameloblastic carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Dec;112(6):767-76. doi: 10.1016/j.tripleo.2011.06.036. Epub 2011 Oct 19. PMID: 22014999.

Lei Y, Jaradat JM, Owosho A, Adebiyi KE, Lybrand KS, Neville BW, Müller S, Bilodeau EA. Evaluation of SOX2 as a potential marker for ameloblastic carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 May;117(5):608-616.e1. doi: 10.1016/j.oooo.2014.01.017. Epub 2014 Jan 20. PMID: 24603057.

Kim J, Ellis GL. Dental follicular tissue: misinterpretation as odontogenic tumors. J Oral Maxillofac Surg. 1993 Jul;51(7):762-7; discussion 767-8. doi: 10.1016/s0278-2391(10)80417-3. PMID: 8509916.

Takahashi H, Fujita S, Okabe H. Immunohistochemical investigation in odontogenic myxoma. J Oral Pathol Med. 1991 Mar;20(3):114-9. doi: 10.1111/j.1600-0714.1991.tb00903.x. PMID: 2037972.

Lombardi T, Lock C, Samson J, Odell EW. S100, alpha-smooth muscle actin and cytokeratin 19 immunohistochemistry in odontogenic and soft tissue myxomas. J Clin Pathol. 1995 Aug;48(8):759-62. doi: 10.1136/jcp.48.8.759. PMID: 7560205; PMCID: PMC502805.

Martínez-Mata G, Mosqueda-Taylor A, Carlos-Bregni R, de Almeida OP, Contreras-Vidaurre E, Vargas PA, Cano-Valdéz AM, Domínguez-Malagón H. Odontogenic myxoma: clinico-pathological, immunohistochemical and ultrastructural findings of a multicentric series. Oral Oncol. 2008 Jun;44(6):601-7. doi: 10.1016/j.oraloncology.2007.08.009. Epub 2007 Nov 8. PMID: 17996487.

Morgan PR, Shirlaw PJ, Johnson NW, Leigh IM, Lane EB. Potential applications of anti-keratin antibodies in oral diagnosis. J Oral Pathol. 1987 Apr;16(4):212-22. doi: 10.1111/j.1600-0714.1987.tb02068.x. PMID: 2442335.

Chu PG, Weiss LM. Keratin expression in human tissues and neoplasms. Histopathology. 2002 May;40(5):403-39. doi: 10.1046/j.1365-2559.2002.01387.x. PMID: 12010363.

Karantza V. Keratins in health and cancer: more than mere epithelial cell markers. Oncogene. 2011 Jan 13;30(2):127-38. doi: 10.1038/onc.2010.456. Epub 2010 Oct 4. PMID: 20890307; PMCID: PMC3155291.

Bishop JA, Montgomery EA, Westra WH. Use of p40 and p63 immunohistochemistry and human papillomavirus testing as ancillary tools for the recognition of head and neck sarcomatoid carcinoma and its distinction from benign and malignant mesenchymal processes. Am J Surg Pathol. 2014 Feb;38(2):257-64. doi: 10.1097/PAS.0000000000000119. PMID: 24418859; PMCID: PMC4313886.

Li LT, Jiang G, Chen Q, Zheng JN. Ki67 is a promising molecular target in the diagnosis of cancer (review). Mol Med Rep. 2015 Mar;11(3):1566-72. doi: 10.3892/mmr.2014.2914. Epub 2014 Nov 10. PMID: 25384676.

Turk AT, Wenig BM. Pitfalls in the biopsy diagnosis of intraoral minor salivary gland neoplasms: diagnostic considerations and recommended approach. Adv Anat Pathol. 2014 Jan;21(1):1-11. doi: 10.1097/PAP.0000000000000000. PMID: 24316905.

Iyer J, Hariharan A, Cao UMN, Mai CTT, Wang A, Khayambashi P, Nguyen BH, Safi L, Tran SD. An Overview on the Histogenesis and Morphogenesis of Salivary Gland Neoplasms and Evolving Diagnostic Approaches. Cancers (Basel). 2021 Aug 3;13(15):3910. doi: 10.3390/cancers13153910. PMID: 34359811; PMCID: PMC8345412.

Ibrahim TR, Ahmed MM, Hegazy AA. Diagnostic Utility of Immunohistochemical Expressions of IMP3 Versus DOG1 and p63 in Salivary Gland Tumors. Turk Patoloji Derg. 2020;36(3):227-236. English. doi: 10.5146/tjpath.2020.01496. PMID: 32692399.

Cheuk W, Chan JK. Advances in salivary gland pathology. Histopathology. 2007 Jul;51(1):1-20. doi: 10.1111/j.1365-2559.2007.02719.x. Epub 2007 May 31. PMID: 17539914.

Chitturi RT, Veeravarmal V, Nirmal RM, Reddy BV. Myoepithelial Cells (MEC) of the Salivary Glands in Health and Tumours. J Clin Diagn Res. 2015 Mar;9(3):ZE14-8. doi: 10.7860/JCDR/2015/11372.5707. Epub 2015 Mar 1. PMID: 25954719; PMCID: PMC4413169.

Received 2022-07-11
Accepted 2023-02-17
Published 2023-06-05