الفهرس 
pathology of cholesteatomaOnly 14 pages are availabe for public view
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Abstract
The present study showed that the Ki-67, TNF- and ICAM-1 had statistically significant more positivities in cholesteatomatous group rather than the control group. These results indicate that cholesteatoma is a hyperproliferative tissue with an inflammatory process. The present study showed that the TNF- and ICAM-1 immunomarking in cholesteatomatous group had statistically significant positive correlations with some indicators of the cholesteatoma aggressiveness as the severity of bone destruction and the presence of complications and with the degree of its inflammatory status. Thus, the severity of the degree of inflammatory status is considered as one of the main factors determining the aggressiveness of cholesteatoma and its associated bone destruction via many mechanisms as TNF-ct stimulatory effect on ICAM-1 expression. The present study revealed that the Ki-67 positivity, considered as a proliferation marker in cholesteatoma, has statistically significant positive correlations with the severity of bone destruction and the presence of complications. Thus, the hyperproliferative power of cholesteatoma is one of the determining factors of its aggressiveness. Also, Ki-67 had statistically significant positive correlations with the degree of the inflammatory status of cholesteatoma, TNF- and ICAM-1. So, the cellular hyperproliferation of cholesteatoma is directly linked to the inflammatory process associated with it through cytokines released in its matrix as TNF- with its effect on ICAM-1 expression. Ki-67, TNF- and ICAM-1 have statistically significant positive correlations with the aggressiveness and hyperproliferative ability of cholesteatoma. So, they can be used as predictors of the biological behaviour of cholesteatoma. There are no statistically significant differences of the Ki-67, TNF- and ICAM-1 levels in pediatric and adult cholesteatomas. Thus, the observed clinical more aggressive behavior of pediatric cholesteatoma is likely due to factors other than hyperproliferative ability of cholesteatoma or its inflammatory status.