Tumor Angiogenesis in Vulvar Squamous Cell Carcinoma

Abstract

Objective.Angiogenesis has been shown to correlate positively with the presence of metastatic disease in some tumors, but has not been studied in invasive vulvar squamous cell carcinoma. Fifty cases of invasive vulvar squamous cell carcinoma were studied in an effort to correlate angiogenesis with stage, survival, and pattern of invasion.Methods.These patients were diagnosed between 1987 and 1993. Microvessels were identified immunohistochemically using antibody to Factor VIII, and areas of greatest microvessel density associated with tumor were counted. The pattern of invasion was categorized as “spray,” “pushing,” or “mixed.” The mean microvessel count was correlated with surgical and clinical stage, pattern of invasion, and survival.Results.Mean microvessel counts in surgical stage I/II cases (31.1 ± 7.3) were not significantly different from stage III/IV cases (26.3 ± 8.6) (P= 0.089). Similarly mean microvessel counts in clinical stage I/II cases (31.6 ± 11.9) were not significantly different from stage III/IV cases (27.0 ± 8.7) (P= 0.198). Seventeen patients who died of disease had mean counts of 26.1 ± 6.4, while 21 patients alive with or without evidence of disease had counts of 31.1 ± 10.8 (P= 0.087). Mean microvessel counts did not vary significantly with the spray pattern (30.1 ± 8.7), pushing pattern (31.4 ± 12.9), or mixed pattern of invasion (31.4 ± 12.9) (P= 0.920).Conclusions.Tumor angiogenesis in vulvar squamous cell carcinoma does not correlate positively with stage, survival, or pattern of invasion and cannot be used as a prognostic indicator.