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Lymph Node Metastases in Oral Cancer: Clinical Implication of the Vascular Endothelial Growth Factor-C Expression by Malignant Cells

Issue: Vol.10, No.4 - October 2011

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Article Type: Manuscript

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  1. Dr Denise Tostes Oliveira
    Bauru School of Dentistry, Pathology Division of the Stomatology Department,
  2. Dr Simone Eloiza Sita Faustino
    Department of Stomatology, Area of Pathology, Bauru School of Dentistry - University of Sao Paulo,
  3. Dr Maria Jaquelini Dias dos Santos
    Department of Stomatology, Area of Pathology, Bauru School of Dentistry - University of Sao Paulo,
  4. Dr Suely Nonogaki
    Adolfo Lutz Institute, Patholofy Division,
  5. Dr Gilles Landman
    Department of Pathology, Cancer Hospital A. C. Camargo,
  6. Dr Luiz Paulo Kowalski
    Department of Head and Neck Surgery and Otorhinolaryngology, Cancer Hospital A. C. Camargo

The vascular endothelial growth factor-C (VEGF-C) overexpressed by malignant cells has been correlated to occurrence of lymph node metastases in patients with oral squamous cell carcinoma (OSCC). However, the lack of standardization of a microscopic evaluation of the VEGF-C expression in oral cancer that reflects more accurately the behavior of the tumor seems to be a factor that hinders the reproduction of some results in the literature. The objective of this study was to evaluate the different scoring systems used for microscopic analysis of immunohistochemical expression of VEGF-C by malignant cells and to establish a more reliable and reproducible methodology that enables contribute to the use of VEGF-C as an adjuvant in therapeutic strategy for adequate indication of the patients to the lymph node neck dissection, especially in early clinical stages of OSCC. Sixty four OSCC arising in the tongue or floor of mouth, clinically T1N0M0 and T2N0M0, with (pN+) and without (pN0) occult lymph node metastases were analyzed for VEGF-C immunoexpression using different methods of subjective scores. Chi-square test or Fisher’s exact test was used to analyze the association of VEGF-C expression with the clinical characteristics, treatment and outcome of the patients. No statistically significant association was observed among the VEGF-C expression by malignant cells, the clinical variables, the follow up informations and the occurrence of occult lymph node metastasis. These results reinforce that, regardless of the microscopic scoring system performed, the isolated immunoexpression of VEGF-C by malignant cells is not predictive factor for occurrence of occult lymph node metastases in early stages of OSCC.

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