Angiogenesis and Tumor-Associated Macrophages in Different Grades of Oral Squamous Cell Carcinoma, Verrucous Carcinoma and Epithelial Dysplasia via Immunohistochemical Assessment of Expression of CD34 and CD68 Markers

Document Type: Original Article


1 Associated Professors, Department of Oral and Maxillofacial Pathology, School of dentistry, Mashhad University of Medical Sciences, Dental School, Mashhad, Iran

2 Assistant Professor, Department of Oral and Maxillofacial Disease, School of dentistry, Iran University of Medical Sciences, Dental School, Tehran, Iran

3 General Dentist, School of Dentistry, Mashhad University of Medical Sciences, Dental School, Mashhad, Iran

4 Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Science, Dental School, Karaj, Iran


Background:Squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity, which is highly invasive. Verrucous carcinoma (VC) is the low-grade form of SCC. Epithelial dysplasia (ED) also has a malignant potential. This immunohistochemical (IHC) study aimed to assess angiogenesis and the presence of tumor-associated macrophages (TAMs) in SCC, VC and ED to determine the role of these factors in the progression of dysplastic lesions to neoplasia.
Methods:Two 4 µ-thick sections were made of 43 paraffin blocks (14 SCC, 14 VC and 15 ED lesions confirmed by two pathologists) for IHC staining. The mean microvessel density (MVD) and the number of TAMs were determined by assessing the expression of CD34 and CD68, respectively in each group of lesions. Data were analyzed using the Fisher’s Exact Test, Chi-square, Kruskal Wallis tests and one-way ANOVA with the aid of SPSS version 21.
Results:Expression of CD34 in ED was higher than that in VCand SCC (ED>VC>SCC). Expression of this marker in more severe forms of ED was higher than that in mild forms. This expression was lower in high-grade SCC in comparison to low-grade SCC. Expression of CD68 in SCC was slightly higher than that in VC and ED. Expression of this marker in severe ED was less than that in mild ED. Its expression in high-grade SCC was higher than that in low-grade SCC, but these differences were not significant for CD68. No significant association was noted between the expression of CD68 and CD34 in these lesions.
Conclusion:The increase in the number of TAMs in malignant oral epithelial lesions was related to the type of tumor and its histopathological grade, but no association was found between TAMs and MVD.


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