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.