Cancer stem cells and field cancerization of oral squamous. Concept of field cancerization field cancerization involves the formation of multiple patches of premalignant disease with a higherthanexpected rate of multiple local second primary tumors. Strikingly, we observed that the expression of aldh1 and bmi1 within a single potentially malignant oe lesion significantly correlate with subsequently developing multiple and multifocal carcinomas, which parallels the process of oral field cancerization. Gabusi andrea coordinatore dottorato supervisore prof. Considering the carcinogenetic influence of tobacco and alcohol in the development of multiple primary tumors of the oral cavity, this article highlights an update and a case series of oral field cancerization. Tobacco chewing was associated with the greatest increase in the risk of multiple oral premalignant lesions and may be the major source of field cancerization of the oral cavity in the indian population. Towards the optical detection of field cancerization in. Genetic profiles of field cancerization and intratumoral heterogeneity in oral squamous cell carcinoma presentata da. On the other hand, multiple hits to the normal stem cells in the epithelium will lead to the development of. Pdf on dec 1, 2012, ashish aggarwal and others published oral field cancerization. In those fields of oral epithelium in which the precancerized keratinocytes are already committed to the pathway of cancerization, progression to. Patients with head and neck squamous cell carcinoma hnscc often develop multiple pre malignant lesions. The concept of field cancerization was first introduced by slaughter et al.
Journal of oral and maxillofacial surgery, medicine, and pathology. A new approach to cancer prescreening focusses on detecting field cancerization instead of the tumor itself. There always exists a field with genetically altered cells with a high risk of developing premalignant and malignant lesions. The investigators examined pathology slides from 783 patients with head and neck cancer in an effort to understand the gross changes found in. Carcinogeninduced independent events or micrometastatic deposits. This article highlights an update and a case series of oral field cancerization, considering the carcinogenetic influence of tobacco and alcohol in the development of multiple primary tumors of the oral cavity. The molecular biology of mucosal field cancerization of the. The concept of ofc explains the mechanisms by which second primary tumors opts develop opts are the tumor, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. It is essential to identify and to treat this field in order to have greater chances to prevent cancer and achieve a better outcome.
Notwithstanding extended surgical approaches or adjuvant chemoradiotherapy, the development of multiple neoplastic lesions arising in the oral cavity after treatment still represents a critical clinical challenge in the management of patients with oral squamous cell carcinoma. The presence of a field with genetically altered cells is a risk factor for cancer. Concurrent multiple oral malignant and potentially malignant. Mar 17, 2016 oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon, but rather as an anaplastic tendency involving many cells at once that results into a multifocal development process of cancer at various rates within the entire field in response to a carcinogen, such as in particular tobacco. The management of patients with field cancerization of the oral mucosa, with multicentri of invasionc foci, presents a considerable proble form th heae d and neck surgeon. Introduction the oral cavity is one of the predominant and prevalent sites of development of potential malignanciesdirect contact with many carcinogens. Tobacco introduction the concept and term field cancerization was first put forward byslaughterandhis coworkers in. Tobacco introduction the concept and term field cancerization was first put forward byslaughterandhis coworkers in 1953. Jun 09, 2017 field cancerization 1953 slaughter et al 783 patients with oral scc 88 11. Oral field cancerization europe pmc article europe pubmed. Field cancerization is a phenomenon in which prolonged exposure to. May 17, 2019 oral field cancerization is probably a general phenomenon of epithelial tumors. Aug 16, 2018 development of field cancerization in the clinically normal oral mucosa of shisha smokers.
An update find, read and cite all the research you need on researchgate. An increase in detection of earlystage asymptomatic lung tumors could increase the overall survival rate of lung cancer patients. The objective of this study was to investigate the use of optical spectroscopy to detect field cancerization in the buccal mucosa of lung. Dec, 20 the term field cancerization has been utilized to explain the followings. Oral field cancerization is a process of malignant transformation. Field cancerization also called field defect or field effect is a well known process of transformation o f an existing precancerous lesion into a malignancy. Index terms field cancerization, multiple oral carcinomas, oral cancer. Second primary tumors and field cancerization in oral and. Field cancerization is a wellknown and welldocumented process of malignant transformation first coined by slaughter et al. Definition oral cancer develops in the multifocal areas of precancerous change histologically abnormal tissue surrounds the tumor oral cancer. The poor outcomes in oral cancer prevention and treatment can be due to nature of the spread of genetically altered cells as fields within the epithelial.
They hypothesized that the entire epithelial surface of the uadt has. The term field cancerization was introduced in 1953 to describe histologically abnormal tissues surrounding oral squamous cell carcinoma, particularly in the upper aerodigestive tract, likely related to exposure to carcinogens. Microscopic evidence of multicentric origin abnormal and hyperplastic, atypical, epithelium surround all oral cancers for varying distances. Pdf there always exists a field with genetically altered cells with a high risk of developing premalignant and malignant lesions. Aug 16, 2018 thus, this study aimed to detect p53 expression in clinically normal oral mucosa of shisha smokers, cigarette smokers, simultaneous smokers and nonsmokers, as a surrogate marker for field cancerization and to detect cyfra 21. Development of field cancerization in the clinically. Feb 01, 2014 oral field cancerization is a process of malignant transformation. Oral field cancerization though not a new concept, has time and again, proven to be a challenge to the clinician, in terms of diagnosis and management. Jul 01, 2015 the cscs of the field can also migrate cd44 h aldh1a1 h laterally to spread the field or get implanted at a new site and form a genetically similar tumor at a later stage signifying the monoclonal mode of field cancerization. Organ systems in which field cancerization has been described since then are. Field cancerization in oral stratified squamous epithelium. Further, the clinical implications and future research directives are also discussed. A genetic explanation of slaughters concept of field. The concept of ofc explains the mechanisms by which second primary tumors opts develop opts are the tumor, which develop in the oral cavity in.
Cancer stem cell markers aldh1 and bmi1 expression in oral. It may often happen that an individual stem cell is genetically altered and can cause the formation of a clone or a patch which is likely to turn into a tumor. The environmental carcinogens reach simultaneously a large area and can. This article reports concepts, theories and markers for the assessment of field cancerization.
Presence of multiple primary tumors may adversely affect the diagnosis and treatment of the oral cancer. The concept of field cancerization describes the tendency of patients with premalignant and malignant lesions of head and neck mucosal sites to develop multiple carcinomas of the upper aerodigestive tract. This explains the higher recurrence rates following tumor resections. An important physiologic function of epithelia is their protective role that inevitably exposes them to environmental substances, including carcinogens that can create a vast area of genetically altered cancer fields. Field cancerization of oral cavity a case series with. This theory has been used to describe the occurrence of primary tumors at multiple sites and recurrences following complete excision. Clinical implications of multicentric origin danely p. Oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon but rather as an anaplastic tendency involving many cells at once and results in the multifocal development of cancer at various rates within the entire field in response to a carcinogen especially tobacco.
The concept of oral field cancerization ofc has been ever changing since its first description by slaughter et al in 1953. Nov 01, 2015 the field lesion suggests the presence of one or more areas consisting of epithelial cells which have genetic alterations. The molecular biology of mucosal field cancerization of. The management of patients with field cancerization of the oral mucosa. Therefore the authors suggested that oral squamous cell carcinoma originated by the concept of field cancerization where an area of epithelium. Photodynamic therapy of malignant and premalignant lesions. Introduction w orldwide incidence rate of oral cancer is escalating in such a rate that 1 in 8 men and 1 in 10 women can have this disease in their lifetime. Feb 01, 2020 the concept of field cancerization was first coined by slaughter et al. A brief history of the theory of field cancerization is here proposed and future perspectives deriving from new molecular techniques are. Field cancerization is now widely accepted not only in head and neck oncology but also in other anatomical districts as well as in different types of epithelial neoplasia. Introduction oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon but rather as an anaplastic tendency involving many cells at once and results in. Such clinical behavior of oral squamous cell carcinoma is nowadays better known as field cancerization effect as suggested by slaughter, the author that for the first time tried to describe it.
Here we address whether this concept should be extended also to patients affected by oral lichen planus olp, an inflammatory disorder associated with an increased risk of. Oral field cancerization and its clinical implications in the. Field cancerization that refers to the existence of transformed cells in areas adjacent to the primary tumor, has been cancer stem cells and field cancerization of oral squamous cell carcinoma oral oncol. Patients with olp and subsequent development of dysplasia oral squamous cell carcinoma are at risk of having multiple and multifocal neoplastic events of the oral cavity, a phenomenon which parallels the concept of field cancerization of traditional head and neck cancers. Concurrent multiple oral malignant and potentially. Field cancerization that refers to the existence of transformed cells in areas adjacent to the primary tumor, has been. Oral squamous cell carcinoma in relation to field precancerisation. Pdf field cancerization in oral lichen planus stefano. Podoplanin and abcg2 expression in oral erythroplakia.
An overview of the risk factors associated with multiple oral. Each received photofrin 2 mgkg 48 hours prior to photoirradiation with 501002 jcm red laser. Such clinical behavior of oral squamous cell carcinoma is nowadays better known as field cancerization effect as. This finding led to the field of the cancerization. Field cancerization in oral lichen planus sciencedirect.
Field cancerization poses a greater challenge, as it influences the morbidity and mortality of oral cancer patients. Development of field cancerization in the clinically normal. Surgica ol resectiof synchronoun ors metachronous primary squamous cell carcinomas, along. It was proposed to explain the development of multiple primary tumors and local recurrence, and the concept has been further extended to oral. Field cancerization in oral stratified squa mous epithelium. Dec 04, 2020 oral field cancerization though not a new concept, has time and again, proven to be a challenge to the clinician, in terms of diagnosis and management. This concept has been frequently used to explain the occurrence of multiple.
Oral squamous cell carcinoma oscc has a high propensity for local failure, which is attributed to recurrence at the primary site or the development of second primary tumors spt. The finding that hnscc patients often present widespread premalignant lesions and mpts in their uadt led slaughter et al. The large number of preneoplastic cells in the proliferating fields is likely to increase cancer risk dramatically. Field cancerization involves the formation of multiple patches of premalignant disease with a higherthanexpected rate of multiple local second primary tumors. Feb 19, 2020 a casecontrol study confirms that microsatellite assay can identify patients at risk of developing oral squamous cell carcinoma within a field of cancerization. Field cancerization the concept of field cancerization was first introduced by slaughter et al, in 1953 when studying the presence of histologically abnormal tissue surrounding oral squamous cell carcinoma.
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