Grading angiogenesis in oral squamous cell carcinoma: a histomorphometric study

Like normal tissues, tumors require an adequate supply of oxygen, metabolites and an effective way to remove waste products. This is achieved by angiogenesis, which is defined as the process by which new blood vessels are produced by sprouting from preexisting vasculature. There is a large spectrum of physiological and pathological processes in which angiogenesis occur, ranging from tissue hypertrophy, wound healing, and inflammation to tumors.

The present study was designed to morphometrically evaluate the angiogenesis in different grades of oral squamous cell carcinomas (OSCCs) under light microscope by the use of H and E stained sections and to assess that whether the parameters of vascularity like mean vascular density (MVD), mean vascular area (MVA), and total vascular area (TVA) can be used to histologically grade the tumors.

A total of 10 cases each of well-, moderately- and poorly-differentiated SCC cases were retrieved from the archives of the Department of Oral Pathology and Microbiology and were morphometrically analyzed for mean vascular density (MVD), MVA, and TVA. Ten cases of normal oral mucosa were taken as Control. Statistical analysis was done using  SPSS 19.0 version (IBM, Armonk, NY, USA) software for windows. Group mean for MVD, TVA and MVA were calculated for 10 cases of each group. "Student's t-test" was applied to assess the intergroup variation of mean values of MVD, TVA, and MVA.

Our results showed significant differences between all the three parameters, that is, MVD, MVA and TVA when poorly differentiated OSCC was compared with the normal mucosa, well- and moderately-differentiated OSCC. However, when comparison was made between the well- and moderately-differentiated OSCC, the differences in the three parameters were present but not statistically significant.

There was an increased MVD, MVA and TVA in poorly differentiated OSCC, which could be used as an additional criterion to histologically grade the tumor.