Vascular Density and Cell Proliferation in Lower Lip Squamous Carcinoma

Method: forty-two cases of squamous cell carcinoma were obtained from the Oral Pathology Laboratory from Biotechnology Institute of São José dos Campos, São Paulo State University. The inclusion criteria were the diagnosis and a sufficient quantity of material in the paraffin block. The malignancy grade was determined by the method of Bryne et al (1989), by two independent examinators. Immunohistochemistry was made by the Streptavidin-Biotin method to evidence Ki-67 antigen and obtain the proliferation index, CD105 to obtain VMD and D2-40 to determine LMD. Descriptive and inferential statistical analyses were performed by Student’s T test and Pearson correlation test, with a significance level of 5%. Kappa test was utilized do evaluate the concordance between the examinators. 

Result: There was concordance between examinators relating to malignancy grading. Thirty-two cases (76.19%) were classified as high-aggressive and 10 (23.81%) as low-aggressive. The labeling index for Ki-67 showed a great variation with average percentage of 14.3% in 1000 counted cells in each case. The average VMD was 9.89 whereas the LMD was 5.36. There was no correlation among VMD, LMD and proliferation index, however, there was a negative relation between LMD and proliferation index, i.e. the greater the proliferation, the lower the LMD. There was no correlation among VMD, LMD and malignancy grade.

Conclusion: the majority of lower lip squamous cell carcinoma is of the high aggressive type, with a great variation in proliferation index. Vascular micro-density is higher than lymphatic vessel micro-density and there is no correlation of both with proliferation index or malignancy grade. The malignancy grade is independent of the histological grade of malignancy in the lower lip squamous cell carcinoma.