Vascular fractal dimension and total vascular area in the study of oral cancer.

Background. Microvessel quantification has been studied extensively as a factor reflecting angiogenesis in various malignant tumors. The aim of our study was to evaluate the vas- cular fractal dimension and the immunohistochemically positive total vascular area in oral cavity carcinomas in order to assess their potential value as factors reflecting angiogenesis. Methods. Histologic sections from 48 carcinomas and 17 nonmalignant mucosa specimens were evaluated by image analysis using fractal analysis software. Total vascular area was also quantified. Results. Carcinomas presented higher mean values of vas- cular fractal dimension and total vascular area compared to nor- mal mucosa. The difference for the vascular fractal dimension was statistically significant. Conclusions. This study provides evidence that vascular fractal dimension could be used as a reliable factor reflecting angiogenesis in oral squamous cell carcinoma and that there are several statistically significant correlations among total vas- cular area, vascular fractal dimension, nuclear size, and clinico- pathologic factors. V C 2008 Wiley Periodicals, Inc. Head Neck 31: 298-307, 2009