Lesões de células gigantes da região maxilofacial: estudo epidemiológico, revisão da literatura e análise da imunoexpressão de proteínas associada a via pi3k/akt/mtor

Abstract

The maxillofacial region can be affected by giant cell lesions (GCLs), which exhibit distinct clinical behaviors and natures. Among them is the central giant cell lesion (CGCL), a benign osteolytic lesion that can sometimes present aggressive and destructive behavior. It is composed of osteoclast-like giant cells, some of which are cannibalistic, and mononuclear cells. The mechanisms associated with the different biological behaviors of these lesions are not yet fully understood. Given this, this aimed to study the clinical, radiographic, genomic, and proteomic profiles of giant cell lesions of the maxillofacial bones, as well as to investigate whether the PI3K/AKT/mTOR pathway is involved in their pathogenesis. Initially, an occurrence study was conducted on all lesions presenting giant cells in their morphology, diagnosed at the Oral Pathology Service of the Department of Dentistry at the Federal University of Rio Grande do Norte between 1970 and 2023. During this period, 441 cases of giant cell lesions were identified, with peripheral giant cell lesion (PGCL) being the most prevalent (n = 169), followed by central giant cell lesion (CGCL) (n = 104). To identify molecular alterations (genomic and proteomic profiles), a scoping review was conducted. The review was registered in PROSPERO and written following the PRISMA-ScR statement standards. Searches were performed in the PubMed, Scopus, Embase, Web of Science, and CINAHL databases, as well as Google Scholar, focusing on CGCL. Among other findings, the review highlighted that the PI3K/AKT/mTOR signaling pathway may play a role in the pathogenesis of CGCL. In this context, the analysis of the influence of the PI3K/AKT/mTOR pathway on the pathogenesis of PGCL, CGCL (aggressive and non-aggressive), and Giant Cell Tumor (GCT) of the long bones was performed through the immunoexpression of proteins associated with the activation of this pathway (mTOR, PTEN, and pS6). It was found that mTOR and PTEN did not influence the different biological behaviors of the studied lesions. However, the expression of p-S6, the final activator of this pathway, may influence the differences in the biological behavior of GCTs of the long bones compared to GCLs of the maxillofacial complex, independently of mTOR activation.