Vessel Co-option: A Promising Therapeutic Strategy in Oral Squamous Cell Carcinoma

Background Vessel co-option is the mechanism by which cancer cells take over existing blood vessels for their own growth and metabolism. It is often associated with treatment failure and metastasis in tumors of the brain, lung, liver, and skin. Limited studies have highlighted the role of vessel co-option in oral squamous cell carcinoma (OSCC). This study aims to determine the association between vessel co-option in OSCC and the Ki67 labeling index (LI) to ascertain its prognostic role. Methodology In this retrospective study, small biopsy specimens were sent and histopathologically processed to prepare formalin-fixed paraffin-embedded blocks. Only cases diagnosed as OSCC were included in the study. Immunohistochemistry for CD34, p40, and Ki67 was performed. Results The study included 39 OSCC patients. The majority (n = 27; 69.23%) of the patients were in the age group of 31-50 years. The male-to-female ratio was 3:1. Tongue (n = 15; 38.46%) was the most common site, followed by the floor of the mouth (n = 11; 28.21%). The majority (n = 25; 64.10%) of the cases were classified as moderately differentiated squamous cell carcinoma. Microscopically, vessel co-option was noted in 71.79% (n = 28) of the cases. Immunohistochemically, Ki67 LI was >10% in 41.03% (n = 16) of the cases. A statistically significant association was found between Ki67 LI and vessel co-option (p = 0.0013). Conclusions Vessel co-option is a potential determinant of the aggressive potential of OSCC. Histopathological assessment of vessel co-option in conjunction with the Ki67 proliferative index has promising potential for assessing the prognosis of OSCC.