The Prognostic Role of VEGF in Head and Neck Squamous Cell Carcinoma

摘要

Emerging from potentially malignant disorders that in most cases will never become cancerous, head and neck squamous cell carcinoma (HNSCC) is a cancer that is extremely difficult to diagnose early. This late stage diagnosis has allowed limited improvements in overall survival (OS) as patients are prone to local recurrence, secondary primary tumors, and distant metastasis. As a result, it has become vitally important to assess the prognostic value of biological marker screening to provide an avenue for early diagnosis and identification of local recurrence or residual secondary tumor sites. Many characteristic markers such as EGFR, p16, p53 and VEGF that are constitutively mutated in HNSCC have been identified. However, the dysregulation of VEGF marks a landmark mutation that accelerates the diseases progression and spread. An angiogenic protein normally expressed in response to hypoxic conditions, VEGF allows the creation of new vasculature to remove catabolites and bestows resistance to normal cellular apoptotic signals; pathways often employed by chemotherapeutics. Therefore, early identification of VEGF poses a unique opportunity to employ aggressive therapeutic regimens in combination with precision surgical resection to eliminate the cancer before neovascualture invasion has occurred and the tumor has expanded significantly. For this reason, this Review will examine the current literature available on VEGFs role in HNSCC, its value as a prognostic marker.