DEPTH OF THE INVASION AND THE DENSITY OF NEOANGIOGENESIS IN SQUAMOUS CELL CARCINOMA OF LOWER LIP IN PATIENTS WITH AND WITHOUT METASTASIS IN NECK LYMPH NODES

Abstract

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Background. Invasion of the malign cells and the neoangiogenesis (formation of new blood vessels from the existing capillaries) are processes by which the neoplasms exist, promote nutrition and metastasize. Aim. Is to determine the progress of the malign process in SCC of lower lip in patients with and without metastasis, by analysis of the morphological indicators, depth of the invasion and the density of neoangiogenesis. Material and Methods. The material is consisted of operational materials from 60 patients with SCC of the lower lip from the University Clinics for Plastic and Reconstructive Surgery and Maxillofacial Surgery in Skopje. 45 patients were without metastasis and 15 patients were with metastasis in the neck lymph nodes. The specimens were histopathologically prepared on the Institute of Pathology, Medical Faculty of Skopje. The histological sections were stained with h. e. and immunohistochemically stained with antibodies against CD34. The depth of the invasion was measured with software for histomorphologic morphometry, and the values were expressed in micrometers. The density of the neoangiogenesis was determined by counting the blood vessels in each case separately, in the area with the largest vascular density (hot spots). Results and Discussion. The statistical data preparation according to Mann-Whitney U-test showed that the patients with metastasis in the neck lymph nodes have statistically larger depth of tumor invasion for p=0.000083 and larger density of neovascularization which is statistically significant for p=0.00019, compared to the patients without metastasis. Conclusions. The depth of the invasion and the density of the neovascularization in the invasive front of the neoplasm could be considered as good indicators for the tumor progression in the decision making process for further treatment of the patients with SCC of lower lip.