Prognostic Significance of Vascular Endothelial Growth Factor-C Expression and Lymphatic Vessel Density in Supraglottic Squamous Cell Carcinoma

Abstract

Objectives/Hypothesis: Regional lymph node metastases are very common findings of supraglottic cancer. The mechanism of lymphatic metastasis is as yet unknown because there have been no specific markers that could definitely distinguish lymphatic vessels from blood vessels. The aim of this study is to identify the prognostic significance of vascular endothelial growth factor-C (VEGF-C) expression and lymphatic vessel density (LVD) in supraglottic cancer. Study Design: The prognostic value of the VEGF-C and LVD was retrospectively evaluated in an unselected series of patients treated with curative intent for supraglottic cancer. Methods: We investigated lymphatic vessels in 43 subjects who had previously been diagnosed with supraglottic cancer. Immunohistochemical staining was performed with VEGF-C, D2-40, and CD31 monoclonal antibodies on the paraffin-embedded tissues obtained from these patients. The association among the semiquantitative score of VEGF-C stained cancer cells, the density of immunohistochemically stained microvessels, and the prognostic factors of supraglottic cancers were investigated to evaluate the prognostic significance. Results: VEGF-C and LVD showed a statistically significant difference according to the presence of lymph node metastasis and regional recurrence (P<.05). VEGF-C was only associated with disease-free survival and regional recurrence in multivariate analysis (P<.05). Conclusions: VEGF-C and LVD might be useful as predictors of the risk of lymph node metastasis and regional recurrence.