Imunoexpressão de fator de crescimento endotelial vascular em granulomas piogênicos

Abstract

Reactive tumor-like proliferations of the oral cavity are represented by a wide variety of conditions that share similar clinical aspects and therefore may pose a diagnostic challenge. Pyogenic granuloma (PG) is among these lesions and is represented by an exaggerated endothelial response to low-grade chronic irritation leading to intense vascular proliferation, although its exact pathogenesis is still unknown. Clinically, PG presents as an exophytic, erythematous, sessile or pedicled papule or nodule whose main microscopic characteristic is the presence of an intense subepithelial endothelial proliferation within a mixed inflammatory infiltrate. Angiogenesis is a very complex phenomenon regulated by factors that inhibit and stimulate vascular proliferation. The imbalance between these factors lead to physiological or pathological angiogenesis. Vascular Endothelial Growth Factor (VEGF) is a 45kDa pro-inflammatory glycoprotein expressed in the cytoplasm and membrane of various cell types in normal and transformed tissues, which plays an important role in critical stages of the angiogenic process. Thus, the purpose of this study was to analyze the immunohistochemical expression of VEGF in PGs diagnosed at the Oral Pathology Service of UNIFAL-MG, and to correlate such immunoexpression with the clinical aspects presented by these lesions. Results showed PG to be a relatively uncommon pathological condition affecting the oral mucosa. PG preferentially affects women, aged between 20 and 40 years old, Caucasian, and is more prevalently located in the gingiva. Microscopically, the vast majority of PG were ulcerated and the endothleial cells present in the areas subjacent to ulceration revealed intense immunohistochemical staining with anti-VEGF.