Assessment of VEGF, CD-31 and Ki-67 Immunohistochemical Markers in Oral Pyogenic Granuloma: A Comparison with Hemangioma and Inflammatory Gingivitis


1 Department of Oral Pathology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Pathology, Mashhad University of Medical Sciences, Mashhad, Iran

4 Mashhad University of Medical Sciences, Mashhad, Iran


The aim of this study was to evaluate the expressions of two angiogenic immune-markers (CD-31 and VEGF), and one proliferative immune-marker (Ki-67) in oral pyogenic granulomas (PG), hemangiomas (Hem) and inflammatory gingivitis (IG).
Materials and Methods
Sixty cases of PG, Hem and IG (twenty cases each) were examined. Immunohistochemical (IHC) staining was performed based on routine techniques. The microvessel density (MVD) index was also evaluated.
The male to female ratio was 1:2. The mean age was 33.3 years old (±20.52). The reactivity percentages for all three markers (CD-31, VEGF and Ki-67) were significantly higher in PG compared to Hem (56.8%, 13.8% and 23.0% vs. 28.3%, 7.0% and 5.4%, respectively). The mean MVD in PG was also significantly higher than in Hem (26.1±0.11 vs. 13.6±0.08). There was no statistically significant difference between PG and IG.
The current study supports the common nature of pyogenic granulomas and inflammatory gingivitis.


1.Cohen M, Michel Jr. Vasculogenesis angiogenesis, hemangiomas, and vascular malformations. Am J Med Genet 2002; 108:265- 274.
2. Jafarzaddeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006; 48:167-175.
3.Dyduch G, Okoń K, Mierzyński W. Benign vascular proliferations--an immunohistochemical and comparative study. Pol J Pathol 2004; 55:59-64.
4.Dyduch G, Okoń K. Proliferation and apoptosis within the oral mucosa "hemangiomas". Pol J Pathol 2000; 5193-96.
5. Nakamura T. Apoptosis and expression of Bax/Bcl-2 proteins in pyogenic granuloma: a comparative study with granulation tissue and capillary hemangioma. J Cutan Pathol 2000; 27:400–405.
6. Freitas TM, Miguel MC, Silveira EJ, Freitas RA, Galvão HC. Assessment of angiogenic markers in oral hemangiomas and pyogenic granulomas. Exp Mol Pathol 2005; 79:79-85.
7. Yuan K, Jin YT, Lin MT. The detection and comparison of angiogenesis-associated factors in pyogenic granuloma by immunohistochemistry. J Periodontol 2000; 71:701-709.
8. Bishop PW. An immunohistochemical vade mecum. Version date May 2010. Available at: www.eimmunohistochemistry. info. Last accessed: 20 August 2010.
9.Behrem S, Zarkovic K, EsKinja N, Joujic N. Endoglin is a better marker than CD31 in evaluation of angiogenesis in glioblastoma. Croat Med J 2005; 46:417- 422.
10. Toida M, Hasegawa T, Watanabe F, Kato K, Makita H, Fujitsuka H, et al. Lobular capillary hemangioma of the oral mucosa: clinicopathological study of 43 cases with a special reference to immunohistochemical characterization of the vascular elements. Pathol Int 2003; 53:1-7.
11. Pradhan S, Bazan H, Salem R, Gusberg RJ. Intravenous lobular capillary hemangioma originating in the iliac veins: a case report. J Vasc Surg 2008; 47:1346-1349.
12. Walner DL, Parker NP, Kim OS, Angeles RM, Stich DD. Lobular capillary hemangioma of the neonatal larynx. Arch Otolaryngol Head Neck Surg 2008; 134:272-277.
13. Abaalkhail F, Castonguay M, Driman DK, Parfitt J, Marotta P. Lobular capillary hemangioma of the liver. Hepatobiliary Pancreat Dis Int 2009; 8:323-325.
14. Alotaibi HM. An unusual association of recurrent pyogenic granuloma on nevus flammeus in a patient with Von Recklinghausen's disease. Saudi Med J 2009; 30:844-846.
15. Ceyhan AM, Basak PY, Akkaya VB, Yildirim M, Kapucuoglu N. A case of multiple, eruptive pyogenic granuloma developed on a region of the burned skin: can erythromycin be a treatment option? J Burn Care Res 2007; 28:754-757.