Tumor angiogenesis in T1 oral cavity squamous cell carcinoma: Role in predicting tumor aggressiveness

Background. Angiogenesis is necessary for tumor growth and metastasis. In breast and other cancers angiogenesis has been shown to correlate with tumor size, metastatic potential, and prognosis. Some studies of head and neck cancer have shown a similar correlation, although results are inconclusive. This study was performed to determine whether tumor angiogenesis can be used as a prognostic indicator for early oral cancers. Methods. CD-31 immunostaining, the technique of choice for determining microvessel density, was utilized to investigate T1 squamous cell carcinomas of the ventral tongue and floor of the mouth. Results. Adequate staining was achieved in 19 tumors. Seven tumors were deemed aggressive due to either the development of metastases or recurrence. The mean microvessel density in the aggressive patients was 43.1/hpf (range 15-79) and in the nonaggressive patients was 38.6/hpf (range 17-78). Statistical analysis failed to reveal any correlation between tumor aggressiveness and tumor angiogenesis in these early tumors. Conclusions. Tumor angiogenesis failed to predict tumor aggressiveness in T1 oral cavity carcinoma; however, low levels of neoangiogenesis were seen in all cases. For this reason this technique may prove more valuable in more advanced cancers.