Prognostic Value of Microvessel Density and p53 Expression on the Locoregional Metastasis and Survival of the Patients With Head and Neck Squamous Cell Carcinoma

Abstract

Cancer cells need to develop microvessels in order to grow and to establish metastatic foci. A role for the p53 protein in the regulation of the angiogenic process is suggested. This study aimed to investigate the relationship between immunohistochemical expression of microvessel density (MVD), measured by CD31 staining, and p53 protein with clinicopathologic factors, and survival in head and neck squamous cell carcinoma (n=70). Tumor angiogenesis was estimated by determining MVD in areas with the highest number of stained microvessels (hot spots). Clinicopathologic factors and immunohistochemical data were evaluated by χ statistical test and were submitted to binary logistic regression to analyze the risk of presence of lymph node metastasis. Factors that might predict survival were investigated using Cox proportional hazards tests. Differences were considered statistically significant when P<0.05. The percentage of p53-positive cells showed no association with clinicopathologic parameters and MVD. Patients with locoregional metastasis presented statistically significant higher MVD (P=0.043). Individuals presenting head and neck squamous cell carcinoma in posterior sites (P=0.022; OR=3.644) and higher MVD (P=0.039; OR=3.247) had a significant increase in risk of metastasis occurrence. Multivariate analysis showed that presence of lymph node metastasis was statistically significant for overall survival of head and neck carcinoma patients (P=0.006; OR =2.917). The present data suggest that MVD represents a promising diagnostic tool to identify individuals with increased risk for the development of metastatic disease, which is very indicative of poor prognosis.

Prediction of Occult Lymph Node Metastasis in Head and Neck Cancer with CD31 Vessel Quantification

“…Several studies reported an association between primary tumor MVD and nodal metastasis in HNSCC. 17,35-38 A significant association between CD105-MVD and nodal metastasis in cN0 cases was reported with univariate analysis. 35 In this work, we found a significant association between peritumoral CD31-MVD and OLNM through a multivariate approach, thereby allowing to adjust for putative confounding factors such as the T classification.…”

Survivin expression, HPV positivity and microvessel density in oropharyngeal carcinomas and relationship with survival time

“…The patient population included oral cavity, larynx and lower lip cancer patients. De Oliveira et al [ 43 ] observed that patients with locoregional metastases had a higher than average MVD. Another outcome of this study is that the microvascular density has an effect on the survival rate.…”

Galectin-1 expression is associated with tumour immunity and prognosis in gingival squamous cell carcinoma

“…In our study, MVD and LVD of GSCC samples were not correlated with Gal-1 expression of them, but MVD was correlated with lymph node metastasis (p<0.05). Amenkwah et al 35 and De Oliveria et al 36 have suggested that tumour angiogenesis is related to the tumour metastasis in regional lymph nodes, as there was a significant migration of neoplastic cells through blood flow. They also propose that MVD is involved in lymph node metastasis.…”