Study of Microvascular Density and Expression of Vascular Endothelial Growth Factor and its Receptors in Cancerous and Precancerous Lesions of the Eyelids

Background/Aim: Tumor angiogenesis has been the subject of intensive research in recent years in many tumor types. Studies involving epithelial skin tumors are few to date. We evaluated tumor angiogenesis and lymphangiogenesis in cancerous and pre-cancerous lesions of the eyelids using immunohistochemical techniques. Materials and Methods: The study included 147 formalin-fixed, paraffin-embedded samples. We studied cancerous lesions of the eyelid skin such as basal cell carcinoma, squamous and basosquamous cell carcinoma and pre-cancerous lesions such as actinic keratosis and Bowen's disease. We applied immunohistochemical staining using antibodies to investigate angiogenic and lymphangiogenic molecular factors, such as vascular endothelial growth factor (VEGF) and its receptors. We recorded the microvascular density of these tumors by using the marker CD-105, a specific antibody against endoglin protein. Results: Data analysis showed that the molecular factors that control angiogenesis are expressed in high proportions in the tumors studied and that this expression is positively-correlated with tumor microvascular density. Furthermore, correlations emerged with the mean diameter of these tumors. We also found differences in microvascular density between pre-cancerous and cancerous eyelid lesions. Conclusion: Activation of the angiogenic molecular factors results in intratumoral and peritumoral microvascularity formation at initial tumor growth. As the tumor attains a certain size and microvascular network, some VEGF receptors appear to decrease. Tumor angiogenesis appears to be active in cutaneous malignancies of the eyelids; therefore our hypothesis of a potential anti-angiogenic therapy for the studied tumors needs investigation in future studies.