OBJECTIVE:The purpose of this study was to determine the expression of receptor activator of NFkappaB ligand (RANKL) and osteoprotegerin (OPG) associated with bone destruction in periapical cysts and granulomas. STUDY DESIGN:Forty human dental chronic periapical lesions were collected after periapical surgery. The lesions collected were fixed in 10% buffered formalin and histologically processed. At least 2 sections of each specimen were stained with hematoxylin and eosin for microscopic diagnosis. After that, 10 human periapical granulomas and 10 cysts were selected for immunohistochemical analysis for RANKL, OPG, and CD68+. RESULTS:Polymorphonuclear neutrophils, macrophages, endothelial cells, and lymphocytes were stained for RANKL and OPG in both lesions. Epithelial cells were also stained for RANKL and OPG in periapical cysts. Quantitative analysis was conducted and the results were expressed as a ratio of the number of immunostained cells over the total number of cells in the field (n = 100). The ratio of RANKL+/total cells was higher than OPG+/total cells in periapical granulomas (0.553 +/- 0.153 and 0.483 +/- 0.189, respectively; P < .0012; paired t test) and in cysts (0.519 +/- 0.09 and 0.339 +/- 0.117, respectively; P < .0001; paired t test). The ratios of OPG+/total cells (P < .0001; paired t test) and RANKL+/total cells (P < .0322; paired t test) were greater in granulomas than in cysts. However, the ratio RANKL+/OPG+ in granulomas (1.336 +/- 0.723) and cysts (1.404 +/- 0.385) was not significantly different. The ratio of CD68+/total cells was significantly higher in granulomas (0.381 +/- 0.040) than in cysts (0.307 +/- 0.068) (P < .0001; unpaired t test with Welch correction). CONCLUSION:Taking into account the limitations of the experimental approach employed, our findings indicate the presence of RANKL and OPG in cysts and granulomas, strongly suggesting the involvement of these gene products in the development of periapical lesions.

译文

目的:本研究旨在确定与根尖周囊肿和肉芽肿中的骨破坏有关的NFkappaB配体(RANKL)和骨保护素(OPG)受体激活剂的表达。
研究设计:根尖周手术后收集了40例人类牙齿慢性根尖周病变。将收集的病灶固定在10%的福尔马林缓冲液中,并进行组织学处理。每个标本至少2个切片用苏木精和曙红染色以进行显微镜诊断。之后,选择10个人根尖肉芽肿和10个囊肿进行RANKL,OPG和CD68的免疫组织化学分析。
结果:在两个病变中,多形核中性粒细胞,巨噬细胞,内皮细胞和淋巴细胞均进行了RANKL和OPG染色。还对上皮细胞囊肿中的上皮细胞进行了RANKL和OPG染色。进行定量分析,结果表示为免疫染色细胞数与现场细胞总数之比(n = 100)。根尖肉芽肿中RANKL /总细胞的比率高于OPG /总细胞的比率(分别为0.553 /-0.153和0.483 /-0.189; P <.0012;成对t检验)和囊肿中(0.519 /-0.09和0.339 / -分别为0.117; P <.0001;成对t检验)。肉芽肿中OPG /总细胞(P <.0001;成对t检验)与RANKL /总细胞(P <.0322;成对t检验)的比率大于囊肿。然而,肉芽肿(1.336 /-0.723)和囊肿(1.404 /-0.385)中的RANKL / OPG比率没有显着差异。肉芽肿中CD68 /总细胞的比例(0.381 /-0.040)显着高于囊肿(0.307 /-0.068)(P <.0001;采用Welch校正的未配对t检验)。
结论:考虑到实验方法的局限性,我们的发现表明囊肿和肉芽肿中存在RANKL和OPG,强烈暗示这些基因产物参与了根尖周病变的发展。

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