Evaluation of lymphangiogenesis in premalignant conditions of the head and neck mucosa.

BACKGROUND Our aim was to determine whether lymphangiogenesis occurs in the early steps of cancerogenesis of the upper aerodigestive tract. METHODS We assessed the number of lymphatics per unit area (lymphatic vascular density [LVD]) and the percent area occupied by the lymphatic vessels (lymphatic vascular area [LVA]) by computer-assisted morphometric analysis in 56 samples immunohistochemically stained with the lymphatic marker D2-40. The results were compared to those obtained in 63 invasive squamous cell carcinomas. RESULTS No significant difference was observed between normal mucosa, hyperplasia/mild dysplasia, and moderate/severe dysplasia for LVD (p = .8) and LVA (p = .7). Conversely, invasive carcinomas presented a higher LVD than normal mucosa and precancerous lesions (p < .001), whereas there was no difference for LVA (p = .1). CONCLUSION Lymphangiogenesis does not occur in premalignant lesions of the upper aerodigestive tract and it is rather a late event associated with the development of an invasive phenotype.