Expression of Vascular Endothelial Growth Factor (VEGF) in Oral Squamous Cell Carcinoma:An Immunohistochemical Study

Objectives: Angiogenesis is an important factor causing the progression of oral squamous cell carcinoma (OSCC). Vascular endothelial growth factor (VEGF) is the most compelling proangiogenic factor. It enhances endothelial cell mitogenesis, mobilisation, cell migration and differentiation through intracellular signaling by binding to specific VEGF receptors. Patients with advanced stages of OSCC show an increased VEGF expression with predilection of local or regional disease relapse and overall shorter survival.
Methods: A total of 50 cases of OSCC with different histological grades and subtypes were recruited and relevant socio demographic and clinical findings were recorded. VEGF expression was seen as brown cytoplasmic staining in tumor, vascular endothelial, inflammatory and stromal cells and fibroblasts .VEGF immunopositivity in the tumour cells was scored by following the criterion of Yanamoto et al (2007) ; total score was calculated as the product of the proportion and intensity scores with the maximum score being 12. Overexpression of VEGF was defined as the total score greater than 4.
Results: Male to female ratio was found to be 1.5: 1. Overall mean age was 52.74±14.14 years. Clinically, patients presented with ulceration (74 %), fungating mass (18%), and plaque-like lesion (8%).Conventional squamous cell carcinoma 94% while only 6% verrucous carcinoma subtypes. A total of 64%, 24% and 12% tumours were well, moderately and poorly differentiated respectively. VEGF overexpression was observed in 92% of OSCC with the higher score (Mean score=10) in poorly differentiated tumours (p=0.010). Statistically, no significant association was found between VEGF expression and OSCC subtype.
Conclusions: VEGF may be considered as a reliable marker to determine tumour angiogenesis and progression.