Elsevier

Oral Oncology

Volume 40, Issue 3, March 2004, Pages 321-325
Oral Oncology

Expression of vascular endothelial growth factor and prognosis of oral squamous cell carcinoma

https://doi.org/10.1016/j.oraloncology.2003.08.020Get rights and content

Abstract

The correlation between expression of vascular endothelial growth factor (VEGF) and prognosis for oral squamous cell carcinoma was investigated. Tissue samples of oral squamous cell carcinoma were obtained from 63 patients. Of these patients, 11 had stage I, 17 had stage II, 9 had stage III, and 26 had stage IV tumours. Immunohistochemical expression of VEGF was quantitatively determined by computer-assisted image analysis. The value of VEGF expression was significantly higher for the patients with poor prognosis than for those with good prognosis (P=0.0423). Regarding regional lymph node metastasis, VEGF showed no significant difference between metastasis positive and negative patients. Expression of VEGF may thus be a prognostic marker for oral squamous cell carcinoma.

Introduction

Tumour growth and metastasis is associated with angiogenesis.1 Vascular endothelial growth factor (VEGF) is currently considered a leading candidate among the factors causing tumour angiogenesis. VEGF is a heparin-binding, dimeric polypeptide growth factor, and its mitogenic activity is specific for vascular endothelial cells.2, 3, 4, 5 Some studies have shown that the expression of VEGF is an independent prognostic factor in patients with breast cancer,6, 7 colon cancer8 and oesophageal squamous cell carcinoma.9 However, few studies have reported the correlation between VEGF expression and prognosis of oral squamous cell carcinoma.10

In the present study, we immunohistochemically assessed the expression of VEGF in oral squamous cell carcinomas, and evaluated the correlation between VEGF expression and their prognosis.

Section snippets

Patients and tissue samples

Biopsy specimens of squamous cell carcinoma were obtained with informed consent from 63 patients at the Second Department of Oral and Maxillofacial Surgery, Nagasaki University Dental Hospital during the 12 years period from 1987 to 1999 (Table 1). All patients were staged according to the tumour-node-metastasis (TNM) classification of tumours (Union Internationale contre le Cancer (UICC), 1987). Eleven patients had stage I, 17 patients had stage II, 9 patients had stage III, and 26 patients

VEGF expression

VEGF expression was found to be present in all specimens (Fig. 1). VEGF expression was mainly confirmed by the presence of brown stained cytoplasm in tumour cells, and was observed in vascular endothelial cells as well. Furthermore, infiltrating inflammatory cells in the tumour were stained strongly.

Relationship between VEGF expression and regional lymph node metastasis

Eighteen patients (28.6%) had regional lymph node metastasis. The average percentage of VEGF immunopositive area (PVIA) was 19.4% in patients who had metastatic lymph nodes, while it was 24.0% in

Discussion

The correlation between prognosis of oral cancer and proliferative activity of tumour cells has been investigated using proliferating cell nuclear antigen,12, 13, 14, 15 BrdU,16, 17 silver-binding nucleolar organizer regions12, 18 and Ki-67.15 Furthermore, oncogenes such as p53,15, 19, 20 c-myc21 and bcl-220 have also been investigated as predictive markers of prognosis for oral cancers. To some extent, these markers could reflect their malignancy and clinical outcome.

Angiogenesis plays an

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