Association Between Human Papillomavirus (HPV) Oncoproteins E6 and E7 and VEGF Expression in Oral and Oropharyngeal Squamous Cell Carcinoma

Background: Oral and oropharyngeal squamous cell carcinoma (OSCC) represents a significant global health challenge. While human papillomavirus (HPV) infection and angiogenesis are known contributors to carcinogenesis, the relationship between HPV oncoproteins and vascular endothelial growth factor (VEGF) expression remains poorly understood. Objective: This study investigated the immunohistochemical expression of VEGF and its association with HPV E6 and E7 oncoproteins in oral and oropharyngeal squamous cell carcinoma, along with their correlation to clinicopathological parameters. Methods: We conducted a cross-sectional study of 80 newly diagnosed OSCC cases. Immunohistochemical analysis was performed to detect VEGF expression and HPV E6/E7 oncoproteins. Expression patterns were correlated with clinicopathological features including tumor differentiation, stage, and lymph node involvement. Results: VEGF expression was detected in 85% of cases, with significantly higher expression in carcinoma compared to adjacent dysplastic tissue (p=0.004). HPV16/18 E6 positivity was observed in 37.5% of cases, while E7 (HPV16) and E7 (HPV18) were positive in 26.25% and 20% of cases respectively. VEGF expression significantly correlated with tumor differentiation (p=0.012) but showed no significant association with HPV oncoprotein expression. No significant correlations were found between VEGF expression and other clinicopathological parameters including age, gender, tumor size, and lymph node status. Conclusion: Although VEGF expression and HPV infection are crucial elements in oral and oropharyngeal tumor progression, their mechanisms appear to be independent. The significant increase in VEGF expression during malignant transformation highlights its role in promoting vasculogenesis within the tumor microenvironment, suggesting VEGF as a potential therapeutic target, particularly in early-stage disease. These findings contribute to the understanding of angiogenic mechanisms in OSCC and may support the development of targeted therapies.