Vascularity and Vascular Endothelial Growth Factor Expression in Oral Carcinoma

Angiogenesis is essential for tumour growth and metastasis. Stimulators of angiogenesis, such as vascular endothelial growth factor (VEGF), as well as vascularity have been shown to be of prognostic significance in a number of tumours at different sites. However, the role of vascularity as a predictor of the likelihood of lymph node metastasis in oral cancer is unclear. Objectives: Therefore, the aim of this study was to investigate the expression of vascular endothelial growth factor (VEGF) and angiogenesis (vascularity) to determine their association with prognosis. Methods: This was performed at three specific regions: the tumour (intra and peri-tumour); the resection margin; and the regional lymph nodes. Formalin fixed paraffin embedded specimens from 26 oral cancers (11 node negative, 15 node positive) were immunohistochemically stained and assessed. Results: VEFG staining was significantly greater in the tumour. No statistically significant differences were found for the primary tumour, resection margins or nodes when comparing node positive to node negative cases. No correlation was found between vascularity and VEGF staining suggesting that VEGF is not the primary or only stimulator of angiogenesis in oral cancer. Conclusion: Greater understanding of the mechanisms of metastasis will lead to novel therapies. The evidence accumulating for oral cancer would seem to suggest that such therapies may be better targeted at preventing lymphatic spread, rather than vascular spread.