VEGF Expression in Head and Neck Squamous Cell Carcinoma: Association with TNM Staging and Tumor Progression

Conventional TNM staging in head and neck squamous cell carcinoma (HNSCC) does not fully capture the molecular heterogeneity driving tumor aggressiveness. Identifying accessible biomarkers that complement staging is therefore a clinical priority. This retrospective study evaluated immunohistochemical VEGF expression in 50 histopathologically confirmed HNSCC cases and examined its association with TNM staging and clinicopathological parameters. VEGF expression was assessed using a semi-quantitative immunoreactivity score (IRS; range 0-12; median 5; IQR 3-8). High VEGF expression (IRS ≥ 4) was identified in 64% of cases and was significantly associated with advanced tumor stage (III-IV; p = 0.032), higher T stage (T3-T4; p = 0.041), and regional lymph node metastasis (p = 0.018). Multivariate logistic regression confirmed nodal status as an independent predictor of high VEGF expression (OR = 2.85; 95% CI 1.12-7.24; p = 0.028). These findings indicate that VEGF expression is associated with adverse pathological features and markers of tumor progression in HNSCC. In the absence of survival data, prognostic conclusions cannot be drawn; prospective studies with survival endpoints are required to establish the clinical utility of VEGF as a prognostic biomarker.