Enhanced tumor angiogenesis and lymphangiogenesis in VEGF-A transgenic mice. Immunofluorescence analysis with antibodies against CD31 (green) and LYVE-1 (red) of PMA-treated skin (A and B), early papillomas (C and D) and SCC (E and F) of wild-type (A,C,E) and VEGF-A transgenic mice (B,D,F) demonstrate highly increased vascularization of papillomas and SCC in both genotypes, as compared with PMA-treated skin. Tumor angiogenesis and lymphangiogenesis were more prominent in VEGF-A transgenic mice (D and F) than in wild-type mice (C and E). Note enlargement of blood vessels (green) and lymphatic vessels (red) in VEGF-A transgenic mice. (G and H) Double-immunofluorescence analysis of SCC for the proliferation marker BrdU (green; arrowheads) and the lymphatic marker LYVE-1 (red) revealed numerous proliferating lymphatic endothelial cells in VEGF-A transgenic mice (H), as compared with only occasional proliferating lymphatic endothelial cells observed in wild-type mice (G). This indicates that VEGF-A promotes tumor lymphangiogenesis. Nuclei are labeled blue (Hoechst stain). Scale bars = 100 μm. (I–N) Computer- assisted morphometric analysis of normal cutaneous and of tumor-associated lymphatic and blood vessels. (I) Significant increase of the relative area occupied by blood vessels in the peritumoral area (Peri SCC) as well as within SCC (Intra SCC), in VEGF-A transgenic mice (filled bars), as compared with wild-type mice (open bars). (J) The average blood vessel size was increased significantly in the intratumoral and the peritumoral areas of SCC in VEGF-A transgenic mice, as compared with wild-types, whereas the blood vessel density only was increased in the intratumoral areas (K). (L) Significant increase of the relative area occupied by lymphatic vessels in VEGF-A transgenic mice throughout all stages of skin carcinogenesis. (M) Significantly increased lymphatic vessel size in the peritumoral area of SCC, but not in the intratumoral area of VEGF-A transgenic mice. (N) No significant differences were found in tumor-associated lymphatic vessel density between the two genotypes. Data are expressed as mean ± SEM. *P < 0.05; **P < 0.01; ***P < 0.001.