Prognostic Significance of <scp>CD105</scp> ‐Assessed Angiogenesis in Relation to Survival and Clinicopathological Features of Oral Squamous Cell Carcinoma

OBJECTIVE: The aim of this study was to determine the clinical significance of mean vascular density (MVD) using the expression of CD105 (endoglein) to predict the 3- and 5-year survival rates of oral squamous cell carcinoma (OSCC), as well as assess its value for predicting clinical outcomes of OSCC. METHODS: A total of 217 OSCC patients treated surgically between 2010 and 2015 were included. Immuno-histochemistry for CD105 was performed, and MVD was quantified. The correlations of MVD with histopathological (HSPL) grade, the clinical Tumor Node Metastasis (TNM) stage, nodal status and survival were analyzed. Multivariate Cox proportional hazards regression analysis was also performed. RESULTS: The MVD significantly increased with increasing HSPL grade from well-differentiated OSCC to poorly-differentiated OSCC (p < 0.001). MVD was significantly increased for advanced-stage TNM cases (III/IV) and metastatic cases when compared to early-stage and non-metastatic tumors (p < 0.001). Survival analysis revealed an inverse relationship between MVD and both three- and five-year disease-free survival. Patients with low MVD had the highest disease-free survival (3 years: 96.2%, 5 years: 92.7%), whereas those with high MVD had poor survival (3 years: 34.0%, 5 years: 27.9%). Multivariate Cox regression analysis confirmed MVD and HSPL grade as independent prognostic factors for overall survival. CONCLUSION: An elevated MVD by CD105 expression is strongly correlated with aggressive HSPL features, stage, nodal metastasis, and poor prognosis in OSCC. In addition to prognostic information, CD105 has the potential to be a target for anti-angiogenic strategies in OSCC indicating its potential use in clinical risk stratification and planning.