Cholesteatoma Epithelium is Characterized by Increased Expression of Ki-67, p53 and p21, with Minimal Apoptosis

Abstract

Objective To investigate differences in cell proliferation, cell cycle arrest and apoptosis between cholesteatoma and control skin.

Material and Methods Immunohistochemical sections of 15 cholesteatoma and 15 paired control retro-auricular skin samples were examined for Ki-67, p53, p21 and active caspase 3, using image analysis, as well as for DNA fragmentation.

Results The retro-auricular skin samples contained 5.7% ± 3.6%, Ki-67-positive cells and showed a normal expression pattern. In the cholesteatoma epithelium 11.7% ± 9.5% of the cells were Ki-67-positive and these cells were dominantly expressed in the basal and parabasal cell layers. Retro-auricular skin contained 5.8% ± 5.4% p53-positive cells and 1.0% ± 0.9%, p21-positive cells. In the cholesteatoma epithelium 17.8% ± 12.3% of the cells were p53-positive and 14.3% ± 11.6% were p21-positive The expression of Ki-67, p53 and p21 differed significantly between the two groups (p < 0.05). In the cholesteatoma epithelium a positive correlation was found between p53 and p21 expression (p = 0.016). Active caspase 3 positivity and DNA fragmentation were rarely seen in the cholesteatoma epithelium.

Conclusion Our results indicate that increased cell proliferation in cholesteatoma epithelium is accompanied by an increase in p53 and p21 protein levels, whilst apoptosis is minimal.

• Active Caspase 3
• Apoptosis
• Cholesteatoma
• Immunohistochemistry
• Ki-67
• p21
• p53
• Terminal Deoxynucleotide Transferase-mediated dUTP Nick-end Labeling