Prediction of Ameloblastoma Aggresivity with Clinicopathological Examination, BRAFV600E and Ki-67 Genes

Cases of ameloblastoma in young patients with recurrences are increasingly found. It is known that the clinicopathology of aggressive ameloblastoma is associated with mutations in the BRAFV600E and Ki-67 genes. A new strategy is needed for pathogenesis prediction based on demographics, clinical features, and biological behavior of ameloblastoma. This study aims to analyze and predict the scoring of the relationship of demographic factors, clinical characteristics, and biological behavior through BRAFV600E and Ki-67 gene expressions with the aggressivity of ameloblastoma in the population in Indonesia. This study was conducted retrospectively (2014-2020). Analysis was performed on demographic status; local status: impacted tooth, root resorption, tumor location, tumor size, duration of the tumors,lymph node enlargement, the direction of the tumor invasion; radiologic results; postoperative diagnosis; clinicopathological subtype; operation management; recurrence; and BRAFV600E and Ki-67 gene expressions. A total of 45 test samples consisted of 15 males (33.3%) and 30 females (66.7%) with a mean age of 34 years old from the range of 6-65 years old. From the observation of the Odd's ratio value in multivariate analysis, the risk of a person with a BRAFV600E expression ratio: Ki-67 expression ≥ 0.32 to develop aggressive ameloblastoma was 5.62 times greater than someone with a BRAFV600E expression: Ki-67 expression level < 0.32. In addition, the risk of someone who had developed a tumor for ≥12 months was 2.72 times greater than that of < 12 months to develop aggressive ameloblastoma. The risk of a person who had an impacted tooth to develop an aggressive ameloblastoma was 0.857 times lower than that of a person who did not have an impacted tooth.