Expression of enamel proteins and LEF1 in adamantinomatous craniopharyngioma: Evidence for its odontogenic epithelial differentiation

Aims: Adamantinomatous craniopharyngioma (ACP) resembles histologically some odontogenic tumours, such as ameloblastoma and calcifying odontogenic cyst. However, there has been no evidence that ACP differentiates also functionally as odontogenic epithelium. The aim of this study was to gain evidence of odontogenic epithelial differentiation in ACP by means of immunohistochemistry. Among normal human tissues, enamel proteins are expressed exclusively in teeth, and lymphoid enhancer factor 1 (LEF1), in co-operation with β-catenin, play an important role in tooth development. The expression of these proteins is therefore indicative of odontogenic epithelial differentiation. Methods and results: The expression of enamel proteins and LEF1 was examined in 10 adamantinomatous and six papillary craniopharyngiomas. All the ACPs showed a variable degree of enamel protein expression, including amelogenin, enamelin and enamelysin, mainly in ghost cells. LEF1 was also heterogeneously expressed in ACPs; remarkably, its expression pattern was identical to that of nuclear β-catenin accumulation. In contrast, none of the papillary craniopharyngiomas expressed enamel proteins or LEF1. Conclusions: These results suggest that ACP consistently shows odontogenic epithelial differentiation. Since ACPs harbour β-catenin mutation, the inappropriate activation of β-catenin/LEF1 complex-dependent transcription may play a critical role in ACP tumorigenesis.