Microvascular density and vascular endothelial growth factor immunoreactivity as predictors of regional lymph node metastasis from betel-associated oral squamous cell carcinoma.
OBJECTIVE
Neovascularization has profound effects on tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is a mitogen that acts exclusively on endothelial cells. The roles of miscrovascularity density (MVD) and VEGF expression in the progression of oral squamous cell carcinoma (OSCC) have been controversial. The purpose of the present study was to measure the MVD and VEGF expression in a cohort of patients with betel-associated OSCC and to evaluate for possible clinicopathologic correlations.


METHODS
The paraffin sections from 49 subjects with OSCC were subjected to immunohistochemical studies to measure the highest MVD (h-MVD) and cytoplasmic immunoreactivity of VEGF. The findings in the tissue samples were analyzed with regard to the patients' risk factors and clinical course.


RESULTS
The OSCC samples had an average h-MVD score of 27.7/mm(2). VEGF immunoreactivity was positive in 75.5% of samples. Both h-MVD and VEGF immunoreactivity were statistically associated with lymph node metastasis (P =.012 and.037, respectively). A marginally significant association was also noted between the h-MVD and patient survival (P =.056). The age and oral habits of patients, as well as the tumor site and size, did not appear to be correlated with h-MVD or VEGF immunoreactivity.


CONCLUSIONS
The data suggest that both h-MVD and VEGF immunoreactivity may be useful predictors for the progression of a subset of OSCC associated mostly with betel use. Antiangiogenesis therapy might have a role in reducing regional metastasis.
Wong
Yong-Kie
YK
Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan, ROC. a2888@vghtc.vghtc.gov.tw
Liu
Chung-Ji
CJ
Kwan
Po-Cheung
PC
Chao
Shou-Yee
SY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001114:Areca / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000473:pathology / Q000556:secondary*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000098:blood supply / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000473:pathology; D012307:Risk Factors; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
D042461:Vascular Endothelial Growth Factor A