Department of Oral Pathology and Bone Metabolism, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Oral Oncol. 2011 Jul;47(7):588-93. doi: 10.1016/j.oraloncology.2011.04.013. Epub 2011 May 23.
Vascular invasion and lymph node metastasis have been used as histopathological prognosticators of cancers including oral squamous cell carcinoma (OSCC). In addition to metastatic potential via blood vessels, tumor-induced angiogenesis might also be associated with prognosis. However, the efficacy of combined evaluation of vascular invasion and angiogenesis-associated molecules for the prognosis of OSCC remains obscure. This is also the case in lymph node metastasis and lymphovasculogenesis-associated molecules. The aim of this study was to examine factors related to prognosis to improve the accuracy of prognostic prediction of OSCC using vasculogenesis-associated markers. Ninety specimens of patients from 1991 to 2002 with previously untreated OSCC, who underwent either biopsy or surgery, were histopathologically and immunohistochemically analyzed using antibodies for vascular endothelial growth factor (VEGF)-A, VEGF-C, cyclooxygenase (COX)-2 and Midkine. The ninety cases were composed of 72 well-differentiated, 12 moderately differentiated and 6 poorly differentiated OSCC. Efficient models of prognostic prediction were evaluated by extensive statistical analyses. The presence of vascular invasion or lymph node metastasis was confirmed to be significantly associated with poor prognosis in the univariate analysis. Multivariate logic regression analysis suggested that patients with the strongly positive expression of either VEGF-A or VEGF-C had a significant association with poor prognosis even in patients without vascular invasion and in early-stage patients. Neither COX-2 nor Midkine contributed to predict the prognosis of the patients. The strongly positive expression of VEGF-A or VEGF-C was suggested to reinforce the histopathological diagnosis of vascular invasion and improve the accuracy and efficacy of prognostic prediction of OSCC.
血管侵犯和淋巴结转移已被用作包括口腔鳞状细胞癌（OSCC）在内的癌症的组织病理学预后指标。除了通过血管的转移潜能外，肿瘤诱导的血管生成也可能与预后相关。然而，血管侵犯和与血管生成相关的分子联合评估对 OSCC 预后的效果仍不清楚。在淋巴结转移和淋巴管生成相关分子中也是如此。本研究的目的是检查与预后相关的因素，以使用血管生成相关标志物提高 OSCC 预后预测的准确性。1991 年至 2002 年间，90 名未经治疗的 OSCC 患者的标本接受了活检或手术，使用血管内皮生长因子（VEGF）-A、VEGF-C、环氧化酶（COX）-2 和 Midkine 的抗体进行了组织病理学和免疫组织化学分析。90 例病例包括 72 例分化良好、12 例中度分化和 6 例低分化 OSCC。通过广泛的统计分析评估了预后预测的有效模型。单因素分析证实血管侵犯或淋巴结转移的存在与预后不良显著相关。多变量逻辑回归分析表明，即使在没有血管侵犯和早期患者中，VEGF-A 或 VEGF-C 强阳性表达的患者与预后不良显著相关。COX-2 和 Midkine 均不能预测患者的预后。VEGF-A 或 VEGF-C 的强阳性表达提示强化了血管侵犯的组织病理学诊断，并提高了 OSCC 预后预测的准确性和效果。
