ABSTRACT
OBJECTIVES: Angiogenesis is a fundamental process in tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis and it has been identified in a wide variety of malignancies, including head and neck squamous cell carcinoma. However, the regulation of VEGF expression in tumor angiogenesis is not well defined. The tumor-suppressor gene p53 is thought to regulate VEGF. In this study, we examined the role of p53 gene in VEGF expression. PATIENTS AND METHODS: Clinical records of patients who underwent total or partial laryngectomy between 1999 and 2002 were reviewed. Of these, paraffin-embedded specimens of 27 patients (27 males; mean age 55 years; range 39 to 74 years) with a diagnosis of larynx epidermoid carcinoma were immunostained to evaluate VEGF expression, p53 gene status, and microvessel density (MVD). Variables were statistically examined. RESULTS: Vascular endothelial growth factor positive staining was detected in 11 (40.7%) and p53 mutations were identified in 16 (60%) tumors. No association was detected between p53 mutations and VEGF expression (p>0.05). Statistical analysis gave a clear correlation between tumor vascularity and VEGF expression (p<0.05). Vascular endothelial growth factor negative tumors showed a lower mean number of microvessels per microscopic field (29.6+/-6.6) than VEGF positive tumors (40.8+/-15.2). P53 and VEGF expression, and MVD were not correlated with the T-stage, N-status, tumor localization, and histological grading (p>0.05). CONCLUSION: The higher microvessel density in VEGF positive tumors supports the importance of VEGF for tumor angiogenesis in laryngeal carcinoma. However, our results do not support the hypothesis concerning a p53 regulation in the angiogenic process through a VEGF up-regulation.
