Immunohistochemically Detection of Angiogenesis in Oral Pre-Cancerous Lesions Compared with Oral Invasive Carcinomas

Abstract

Background: Angiogenic activity is an important event in oral carcinogenesis. During transition of normal<br />oral mucosa to different grades of dysplasia and to invasive carcinoma, significant increase of vascularity occurs.<br />Angiogenesis can be determined by immunohistochemical assessment of several endothelial cell markers like<br />Endogelin (CD 105), expressed in activated endothelial cells and associated with neovasculature, and the vascular<br />endothelial growth factor (VEGF). This study was conducted to evaluate angiogenic activity in oral precancerous lesions<br />compared with oral invasive carcinomas by immunohistochemical staining of VEGF and CD 105 proteins. Methods:<br />In the present cross-sectional study, 20 normal, 20 pre-cancerous mucosa and 20 oral invasive carcinoma samples<br />were immunohistochemically stained. Positive cells were counted in each section and micro vessel density (MVD)<br />was determined. The data were statistically analyzed by Mann-Whitney and Kruskal-Wallis tests, with a P-value ≤0.05<br />considered significant. Results: The mean expression value for VEGF was 24.6 in oral invasive carcinoma, 16.4 in<br />precancerous mucosa and 15.5 in normal mucosa, with no significant differences between the latter two. Endoglin<br />was negative in all normal mucosa samples, but had scores of 7.58 for precancerous mucosa and 19.4 in oral invasive<br />carcinoma specimens. MVD was significantly higher in SCC than in dysplastic mucosa. Conclusion: Oral invasive<br />carcinoma has more angiogenic activity in comparison with pre-cancerous lesions and normal mucosa. Given the high<br />expression of CD105 positive vessels in malignant lesions, we can argue that determination of mean vessel density (MVD)<br />by application of the CD105 marker could be a useful parameter to differentiate cancerous from pre-cancerous lesions.