Role of Vascular Endothelial Growth Factor (VEGF) in Tumor Progression among Oral Epithelial Dysplasia (OEDs), Verrucous Carcinoma (VC) and Oral Squamous Cell Carcinoma (OSCC) – An Immunohistochemical Study

Abstract

Background: Oral Squamous cell carcinoma (OSCC) is a grave health issue problem worldwide which often leads to compromised life style or sometimes lethal. It positions itself in sixth place among cancer prevalence and is one of the leading cause for death in India. Potentially Malignant Disorders (PMDs) are precursor lesions which has higher potential for transforming into oral squamous cell carcinoma. Tumor angiogenesis is an important biomarker that may govern the progression of precancerous lesion into cancerous lesion. Vascular Endothelial Growth Factor (VEGF) plays a vital part in carcinogenesis by inducing angiogenesis. Angiogenesis is establishment of new blood vessels from prevailing vasculature which is crucial for tumor development, progression and metastasis.

Aim: To evaluate and compare the expression of VEGF among Oral Epithelial Dysplasia (OEDs), Verrucous Carcinoma (VCs) and different grades of Oral Squamous Cell Carcinoma (OSCCs).

Material and Methods: The study comprised of 100 formalin fixed paraffin embedded tissue blocks comprising of 20 cases of OED, 20 cases of VC and 60 cases of OSCC [20 - well differentiated oral squamous cell carcinoma (WD-OSCC), 20 – moderately differentiated oral squamous cell carcinoma (MD-OSCC), 20 – poorly differentiated oral squamous cell carcinoma(PD-OSCC)]. All the cases were immunostained for anti-human VEGF mouse IgG monoclonal antibody. The expression were VEGF evaluated for staining intensity, distribution and statistically analyzed with Analysis of variance (ANOVA), Post hoc Bonferroni test, Independent t-test, Pearson Chi- square test, Pearson correlation coefficient test.

Results: VEGF immunoexpression was found to be increased in the order of OEDs, VC and Oral Squamous Cell Carcinoma OSCC. The percentage of positivity was found to be more in PD-OSCC, followed by MD-OSCC, WD-OSCC.

Conclusion: From our study it was concluded that, angiogenesis plays major role in tumor progression and metastasis. There was significant correlation found between VEGF expression, increases in vascularity during transition from OEDs to VCs and OSCCs.