Expression of Vascular Endothelial Growth Factor is Significantly Associated With Progression and Prognosis of Oral Squamous Cell Carcinomas in Taiwan

Abstract

Expression of vascular endothelial growth factor (VEGF) correlates with progression and prognosis of several human cancers. The main purposes of this study were to assess expression of VEGF in specimens of oral squamous cell carcinoma (OSCC) and to evaluate the possible influence of VEGF on the progression and prognosis of OSCC in Taiwan. An immunohistochemical technique was used to examine the expression of VEGF in 100 specimens of OSCC, 66 specimens of oral epithelial dysplasia, and 36 specimens of normal oral mucosa. We found that the mean labeling indices (Lis) of VEGF increased significantly from normal oral mucosa (13 ± 6%), through mild (22 ± 8%), moderate (24 ± 13%), and severe oral epithelial dysplasia (32 ± 14%), to OSCC samples (50 ± 18%, p < 0.001). The higher mean VEGF LI was significantly related to OSCC with positive lymph node metastasis (p = 0.022) and with more advanced clinical stages (p = 0.046). In addition, positive lymph node metastasis (p = 0.008) and VEGF LI > 40% (p = 0.046) were identified as independent unfavorable prognosis factors for OSCC patients by multivariate analysis with the Cox regression model. Moreover, the Kaplan-Meier curve showed that OSCC patients with a VEGF LI > 40% had a significantly poorer cumulative survival than those with a VEGF LI ≤ 40% (log-rank test, p = 0.016). We conclude that VEGF may be a biomarker for prediction of the progression and prognosis of OSCC in Taiwan.