Expression of Vascular Endothelial Growth Factor (VEGF), Insulin Growth Factor-1 (IGF-1) and DNA Flowcytometric Analysis in Egyptian Patients with Oral Squamous Cell Carcinoma

The aim of the present study was to explore the expression of vascular endothelial growth factor (VEGF), Insulin Growth Factor-1 (IGF-1), DNA-ploidy and S-Phase Fraction (SPF) in oral squamous cell carcinoma (OSCC) and to evaluate their possible clinic pathologic correlations. Twenty cases as healthy subjects and 30 cases were diagnosed as OSCC with different tumor size, grades and lymph node (LN) metastasis. Blood samples from all cases were collected, centrifuged and serum was assayed for VEGF and IGF-1. VEGF was assayed by ELISA and Western blot techniques. IGF-1 was determined by Immunoradiometric assay (IRMA). Tumor and normal tissues of the same patient were analyzed by flowcytometry for DNA-Ploidy and SPF. The mean level of VEGF in sera of OSCC patients was significantly higher than those of healthy control (p=0.0001). Paired t-test between patients with metastasized lymph node and negative ones, showed high VEGF level in lymph node positive subset. ANOVA test showed significantly increased VEGF level with high tumor grade, p=0.0001. t-test showed significantly increased VEGF level in patients with tumor size 3cm in comparing with those of ≤3cm, p=0.0001. The mean level of IGF-1 in OSCC patients was significantly increased compared to the normal control mean. The increased level of IGF-1 was significantly correlated with VEGF level (p=0.006, r=0.49). The mean level of IGF-1 was significantly increased with increasing grade of OSCC, but not correlated neither with lymph node metastasis nor tumor size. Flowcytometric analysis showed that 13/30 cases were diploid (43.3%), and 17/30 were aneuploid (56.75). SPF was low in 19/30 cases (63.7%) and high in 11/30 cases (36.7%). A significant correlation was found between SPF and tumors grade. Grade I tumors had a low SPF, while grade III tumors had a high SPF. Conclusion: The significant correlation between VEGF and IGF-1 expressions may be helpful to distinguish OSCC patients from the normal individuals. Also their expressions were correlated with tumor grades. The combined evaluation of ploidy and SPF allows determination of high-risk patients, requiring more aggressive therapy.