Bcl-2 and galectin-3 expression is associated with recurrence of ameloblastoma.

Background: Ameloblastoma is a benign odontogenic neoplasm with a high recurrence rate. Identifying cellular and molecular changes in this neoplasm may help predict the recurrence risk. Bcl-2 and galectin-3 are anti-apoptotic proteins associated with the prognosis of many neoplasms. However, there are a few studies focusing on the association between these two markers and recurrence of ameloblastoma. This study aimed to investigate the association of Bcl-2 plus galectin-3 expression and recurrence of ameloblastoma.

Materials and methods: This retrospective cross-sectional study was designed on 48 paraffin-embedded blocks diagnosed as ameloblastoma from 1998 to 2019. We retrieved follow-up data from patients' records and used immunohistochemical staining for Bcl-2 and galectin-3 antibodies. Then, we analyzed their association with recurrence using Chi-square and Mann-Whitney test as well as recurrence-free survival using Kaplan-Meier curves and linear Cox regression. The level of statistical significance was P < 0.05.

Results: Twenty-six patients had experienced the recurrence. The mean follow-up time was 93.53 months. There was a significant association between Bcl-2 plus cytoplasmic galectin-3 staining and recurrence (both P < 0.001). Furthermore, in univariate analysis, high expression of Bcl-2 was associated with less recurrence-free survival (log-rank: P = 0.020-univariable Cox: P = 0.033), but in multiple Cox regression, there was no significant association (P = 0.471). High cytoplasmic galectin-3 expression was also associated with less recurrence-free survival (log-rank: P = 0.007-univariable Cox: P = 0.015-multiple Cox: P = 0.044). Furthermore, we found a correlation between Bcl-2 and cytoplasmic galectin-3 staining (P = 0.001).

Conclusion: It seems that Bcl-2 and cytoplasmic galectin-3 staining might predict the risk of ameloblastoma recurrence. However, only the cytoplasmic galectin-3 staining might be an independent predictor of ameloblastoma recurrence, and we recommend further studies.