Increased expression of autophagy-related proteins in keratocystic odontogenic tumours: its possible association with growth potential

The aim of this study was to evaluate the activation status of autophagy in keratocystic odontogenic tumours (KCOT), and to investigate its possible association with growth potential. We detected the expression of some key autophagy-related proteins in clinical samples of KCOT and radicular cysts and compared then by real-time quantitative polymerase chain reaction (qPCR) and immunohistochemical analysis, respectively. The correlation between the autophagy-related proteins tested, and with cell antiapoptotic (Bcl-2) or proliferative (Ki-67) markers in KCOT was explored using Spearman's rank correlation, followed by cluster analysis. The results showed that both the expression of mRNA and the immunoreactivity of the autophagy-related proteins tested were considerably increased in samples of KCOT compared with those in samples of radicular cysts. The correlation analyses showed that the immunostains of autophagy-related proteins in samples of KCOT correlated closely with each other. The immunostains of these autophagy-related proteins also correlated closely with the immunostains of Bcl-2 and Ki-67 in KCOT. More importantly, double-labelling immunofluorescence analyses also showed that the distribution of autophagic and proliferative markers was partially synchronous in samples from KCOT. We have, to our knowledge for the first time, implicated the activation of autophagy in KCOT, and showed its possible association with growth potential.