Avaliação da linfangiogênese em carcinoma de células escamosas de boca e de sua associação com metástases nodais

Abstract

Recent studies have demonstrated that metastatic behavior of some tumors is facilitated by lymphangiogenesesis in primary tumor or in lymph node environment. In the present study of lymphangiogenesis 36 paraffin-embedded samples of oral squamous cell carcinoma (OSCC) and associated lymph nodes were used. Lymphatic vessels and microvessels densities (LVD and MVD) in tumor and in lymph nodes were evaluated by immunohystochemistry using D2-40 and CD105 antibodies, respectively. Also, we analyzed podoplanin (D2-40), VEGF-C and VEGFR-3 neoplastic expressions in primary tumor and in metastatic lymph node. The relationship between the proteins studied and clinicopathologic characteristics was evaluated by association tests. Moreover, the impact of studied variables in overall survival of the patients was analized. High LVD showed an association with size and localization of tumor. MVD showed statistical significance with metastasis and a significant association between the lymphangiogenic factors and the density of vessels in intratumoral region was also seen. None of the well differentiated tumors, showed podoplanin expression in invasion front. LVD and MVD in metastatic lymph nodes demonstrated to be significantly higher when compared with densities in non-metastatic lymph nodes. Also, histologic graduation and peritumoral MVD showed a tendency to be indicators of a poor prognosis in OSCC. Signs of lymphangiogenesis occurrence in OSCC were demonstrated, and the enhanced vascular network in metastatic lymph nodes reinforces the previous reports of lymphangiogenesis occurrence in lymph nodes. Also, the expression of podoplanin by more undifferentiated tumor cells in invasion front, suggest that this expression could be an indicator of tumor aggressiveness.