Cripto-1: A Potential Biomarker for Distinguishing Fibrous Dysplasia, Central Ossifying Fibroma and Osteosarcoma of the Jaws

Abstract

Background: The identification of molecular markers that could be involved in the pathogenesis of fibro-osseous lesions of the jaws may help to understand the different biological behaviors of such group. Aims: The aim of the present study was to compare the immunohistochemical expression levels of Cripto-1 (CR-1) in a series of cases diagnosed microscopically as benign or malignant bone tumors to see if it can help in distinguishing them. Place and Duration of Study: Brazil, Department of Dentistry of Federal University of Rio Grande do Norte, between January 2020 and July 2023. Methodology: Thirty fibrous dysplasias (FD), twenty-eight central ossifying fibromas (COF) and five osteosarcomas (OS) were randomly selected and submitted to immunohistochemical analysis using anti-CR-1 antibody, according to the percentage of immunopositive cells, immunostaining intensity and final immunoreactive score. Results: Analysis of the percentage of cells immunostained for CR-1 revealed a predominance of score 4 for COFs and OSs, whereas most cases of FDs exhibited score 2 (p <0.001). With respect to the immunostaining intensity for CR-1, a higher prevalence of score 3 was observed for COFs and OSs, while most cases of FD showed score 1 (p <0.001). Regarding the final immunoreactive score, a predominance of a strongly positive pattern was identified in COFs and OSs, while a moderate pattern was verified in FDs (p <0.001). Conclusion: Our findings suggest the participation of CR-1 in the pathogenesis of COFs and OSs, as well as the use of this protein as a potential molecular biomarker for clinical investigation, differential diagnosis between COFs and FDs, and, subsequently, for the indication of the appropriate therapy for these lesions. These findings contribute to the diagnosis of fibro-osseous jaw lesions and may guide clinical decision-making.