Frequency of BRAF V600E immunoexpression in ameloblastomas: a multi-institutional analysis of 86 cases in Latin America and comprehensive review of the literature

The initiation of odontogenic tumorigenesis often involves the activation of the MAP-kinase pathway, with a pivotal role played by the BRAF V600E mutation. This study aimed to investigate the frequency of BRAF V600E immunoexpresion in ameloblastomas diagnosed in four Latin American centers and correlate this finding with the histological types and subtypes of the analyzed cases. A total of 86 samples of ameloblastomas were examined for immunohistochemistry using anti-BRAF V600E antibody. The histopathological features of each case were analyzed. Positivity for anti-BRAF V600E antibody was detected in 65/86 cases (75.6%). BRAF V600E was positive in 38/56 cases (67.9%) of conventional ameloblastomas and in 27/30 cases (90.0%) of unicystic ameloblastomas. A statistically significant difference in BRAF V600E positivity was observed when comparing unicystic ameloblastomas to conventional ameloblastomas (p=0.03). No statistically significant difference in BRAF V600E positivity was observed when comparing histological variants, both for conventional ameloblastomas and unicystic ameloblastomas. This study highlights a high frequency of BRAF V600E immunoreactivity in ameloblastomas among Latin American cases. The prevalence of the BRAF V600E immunoexpresion may suggest the feasibility of utilizing BRAF-targeted therapy for ameloblastomas with this mutation.