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Abstract Ameloblastoma and KCOT Ameloblastoma (AM) are most commonly encountered in the jaw bones. The etiopathogenesis is idiopathic. Ameloblastoma (AM) is a very common odontogenic tumor in the oral cavity whose idiopathic nature manipulates scholars and clinicians. The etiopathogenesis of AM is controversial. The involved cellular changes - including proliferation, differentiation, senescence, tumorigenesis, etc - which are identified through the immunohistochemical workup contribute significantly to our contemporary nosology of this aggressive benign tumor. Keratocystic odontogenic tumor (KCOT) is controversially considered a cyst and a tumor. According to WHO, KCOT is a benign, unicystic or multicystic, intraosseous tumor of odontogenic origin. Either syndromic or non-syndromic, the PTCH gene is proven participant in the etiology. This study contrasted the expression of CD44 in AM and KCOT. CD44, a transmembrane glycoprotein, is a homing cell adhesion molecule and is a stem cell marker for breast, prostate, pancreatic cancers and for several head and neck benign and malignant tumors. Receptor Activator of NF-κB (RANK), or CD 256, is a homotrimeric transmembrane protein member of the TNF receptor superfamily. It is normally expressed in mature osteoclasts and in dendritic cells. Oncologically, RANK is known to be expressed in some cancer cells, including breast and prostate cancers. RANKL is produced mainly by the osteoblastic lineage and immune cells, and is able to link to RANK, stimulating bone resorption through osteoclastogenesis and multinucleated mature osteoclasts activation.Forty formalin-fixed, paraffin-embedded specimens were included in this study, twenty cases diagnosed as Ameloblastoma and twenty cases diagnosed as KCOT. Histopathological examination, using haematoxylin and eosin was used to confirm the diagnosis. Using peroxidase-antiperoxidase method for immunohistochemical examination, each lesion was stained with antibodies against CD44 and RANK. Analysis and interpretation of the results was performed using the image analysis software (Image J1.43r) to measure the surface areas of immunopositivity for CD44 and RANK. For all cases, the area fraction of CD44 and RANK immunopositivity for at least four different microscopic fields was measured. Then the mean area fraction of immunopositive cells for each case was calculated and used for statistical analysis. Statistical analysis was performed using student‟s t-test to compare between RCs and KCOTs. Pearson‟s correlation coefficient was used to determine any significant correlation between CD44 and RANK. The immunohistochemical results of the present study demonstrated that.There is a highly significant difference between the immunoexpression of CD44 in AM and OKCT. and also in immune expression of RANK in AM and OKCT. So The results show that KCOT demonstrates a stronger positivity than AM. In conclusion, the breakdown in the cellular adhesion, as a clue to osteoclastogenesis, is stronger in KCOT than in AM. The strong expression of KCOT for the monoclonal antibody of CD44 was against the cystic nature and supports the neoplaticity of KCOT. CD 44 and RANK may play a significant prognostic role in predicting the recurrence of AM and KCOT and may have a synergistic osteoclastic interaction. |