Objectives: Ameloblastoma is a benign but aggressive tumor known for its local invasiveness and tendency to recur. The object of our study was to find genes that contribute to the neoplastic transformation and progression of ameloblastoma by comparing gene expression patterns in ameloblastoma and dentigerous cyst. Clinicopathologic factors related to the recurrence of ameloblastoma were also investigated. Methods: Two hundred thirty four ameloblastomas were retrieved from the Department of Oral Pathology at Seoul National University Hospital from 1990 to 2003. The relationship between recurrence rate and various factors was investigated. Two fresh dentigerous cyst and ameloblastoma specimens were removed during surgery. RNA was isolated, microarray performed using a 34K oligochip, and the results verified using semi-quantitative RT-PCR. Results: Seventy-three genes were overexpressed, and 49 genes underexpressed in ameloblastoma compared to dentigerous cyst more than four-fold. Ten overexpressed genes (Vav3, Smarca2, Pthrp, Cdk2, Clu, Egfr, Tnks, Fubp, Tom1l1, and Klk5) whose functions seemed most pertinent in the development and progression of ameloblastoma were selected and quantitatively verified with semi-quantitative RT-PCR. Clinically, clinicoradiographic type, histologic pattern, age at the time of operation, and treatment modality were shown to be related to recurrence. Conclusion: By comparing gene expression between dentigerous cyst and ameloblastoma for the first time, we identified genes that may play important roles in the pathogenesis of ameloblastoma. Clinically, we identified factors that should be taken into consideration when determining treatment in order to minimize recurrence. Therefore, our study may provide a new approach in determining diagnosis, prognosis, and treatment of ameloblastoma.

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