Although the available treatment modalities for Hodgkin’s lymphoma (HL) are usually successful, a large number of HL patients still relapse after initial therapy. It is, therefore, essential to study the biology of HL, in a trial to improve patients’ outcomes and therapeutic modalities. Angiogenesis is a mandatory step for tumor growth and progression. Vascular endothelial growth factor (VEGF) is one of the principle angiogenic factors to answer the question, ‘which cells are contributing more in angiogenesis of HL and should be attacked first in tumor therapy?’ The present study aimed to evaluate VEGF expression in HL, not only in neoplastic cells but also in non-neoplastic and vascular endothelial cells as contributing members in tumor biology. Differential VEGF expression and tumor microvessel density (MVD) were studied in relation to tumor stage to verify independent predictors of advanced disease.Results
Total VEGF and its differential expression in Reed–Sternberg cells, non-neoplastic cells, and endothelial cells was significantly related to advanced tumor stage. Non-neoplastic VEGF was found to be the single parameter that significantly guides tumor MVD. However, on multivariate analysis, MVD alone was the sole independent predictor of advanced HL with 84.8% sensitivity, 85% specificity, and 17.5 cutoff value.