CD34 Staining Density Predicts Giant Cell Tumor Clinical Behavior
Purpose
To evaluate the staining density of CD34, a glycoprotein expressed in hematopoetic precursor and capillary endothelial cells, as a molecular marker for predicting clinical behavior of giant cell tumors.
Materials and Methods
This was a retrospective study of patients with giant cell lesions of the jaws treated over a 15-year period. The primary predictor variable was mean CD34 staining density. The outcome measure was giant cell tumor clinical behavior (aggressive vs nonaggressive). Bivariate analyses were computed to evaluate the association between the predictors and outcome. A receiver-operator characteristic (ROC) curve was used to establish the threshold for a positive diagnostic test. A logistic regression model was used to evaluate the association between the clinical behavior and a positive test. A value of P ≤ .05 was statistically significant.
Results
The study sample consisted of 32 subjects with a mean age of 24.4 ± 19.8 years (range 2-83), including 23 females (71.8%), treated for giant cell lesions during the study period. The sample included 26 aggressive lesions and 6 nonaggressive lesions, with mean CD34 staining densities of 5.1 ± 3.3% and 2.2 ± 0.7%, respectively (P = .02). Using a CD34 staining level of equal to or more than 2.5% as indicative of a positive test, the sensitivity, specificity, positive and negative predictive values were 0.77, 0.83, 0.95 and 0.45, respectively. CD34 levels of more than 2.5% were significantly associated with aggressive lesions whereas CD 34 levels of less than 2.5% were associated with nonaggressive lesions (odds ratio: 16.7, P = .04).
Conclusions
CD34 staining density levels of more than 2.5% were associated with aggressive giant cell lesions.
⁎Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
†Associate Professor, Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA
‡Formerly, DMD Candidate, Harvard School of Dental Medicine, Boston, MA
§Associate Professor, Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, MA
∥Walter C. Guralnick Professor and Chairman, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine, Boston, MA
¶Director, Center for Applied Clinical Investigation, and Visiting Oral and Maxillofacial Surgeon, Massachusetts General Hospital, and Associate Professor, Harvard School of Dental Medicine, Boston, MA
Address correspondence and reprint requests to Dr Susarla: Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1201, Boston, MA 02114
This study was supported by the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund (S.M.S., N.D.) and the Oral and Maxillofacial Surgery Foundation Fellowship in Clinical Investigation (S.M.S.).
ABSTRACT