Actinic keratosis as a marker of field cancerization in. A genetic explanation of slaughters concept of field. Concurrent multiple oral malignant and potentially. The second theory is based on the concept of field cancer ization. The presence of a field cancerization containing genetically altered cells represents a continuous risk factor to the growth of secondary cancers.
It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. Management of field change is challenging, taking into account the high impact of nmscs on public health and healthcare costs. Jul 19, 2019 field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Pancreatobiliary malignanciesan appreciation of the. Concepts of field cancerization based on clonality models oral field cancerization occurs by either cell migration or development from independent cells. The presence of a field with genetically altered cells is a risk factor for cancer. The molecular biology of mucosal field cancerization of the. Field cancerization is no idely accepted not only in head and nec oncology but also in other anatomical districts as ell as in different types of epithelial neoplasia brief history of the theory of field cancerization is here proposed and future perspectives deriving from ne molecular techniues are discussed correspondence.
Persistence of genetically altered fields in head and neck. The concept of ofc explains the mechanisms by which second primary. Such tumorspecific biomarkers should have excellent clinical utility. In fact, the concept of field of cancerization has led to the use of novel technologies to predict the risk of cancer based on testing of cells from the field. Index terms field cancerization, multiple oral carcinomas, oral cancer. An evolutionary perspective on field cancerization. One of the earliest stages is field carcinogenesis also referred to as field cancerization, field effect, field of injury, field defect, etc. Aug 17, 2016 the most promising marker of field cancerization is p53 which shows a strong positive correlation with the progression of the tumor from a benign to a malignant state 23.
The large number of preneoplastic cells in the proliferating fields is likely to increase cancer risk dramatically. Clinically apparent and subclinical actinic keratoses usually are present in patients, a concept known as field cancerization, and it is important to treat both types of lesions. There are over 60 different organs in the body where you can get a cancer. For example, there is usually a surface covering of skin or. The theory of field effect or field cancerization, firstly described by slaughter in 1953, shows that the tumoradjacent area, besides histopathologica lly normal, undergoes genetic and epigenetic changes that can eventually lead to the development of local recurrence or onset of a second primary.
Field cancerization was a term adopted to explain multifocal oral cancers in which clinically occult multifocal preneoplastic foci emerge within the epithelium of an anatomic region exposed to the same carcinogens slaughter et al. Theory allows us to explain what we see and to figure out how to bring about change. Spatially resolved optical and ultrastructural properties. Field cancerization also termed field change, field change cancerization, field carcinogenesis, cancer field effect or premalignant field defect is a biological process in which large areas of cells at a tissue surface or within an organ are affected by carcinogenic alterations. The concept of field cancerization was first proposed in 1953 by slaughter et al 1 in their study of oral squamous carcinomas. Field cancerization an overview sciencedirect topics. Oral cancer develops in the multifocal areas of precancerous change. An evolutionary perspective on field cancerization nature. Open access ec dental science case report wide field. The concept of oral field cancerization ofc has been ever changing since its first description by slaughter et al in 1953. An overview of the risk factors associated with multiple.
Introduction to quantum field theory were the most di. Field cancerization may be an extended form of the knudson hypothesis. There is now a standard reference on relativistic string theory by green, schwarz, and witten, superstring theory 0. Pancreatobiliary malignanciesan appreciation of the field. Chemoprevention can be performed to halt, delay, or reverse malignant progression in tissues at risk to develop invasive cancer. Field cancerization therapies for management of actinic. Mar 15, 2007 such tumorspecific biomarkers should have excellent clinical utility. Patients with a head and neck squamous cell carcinoma hnscc often develop multiple premalignant lesions.
Recent molecular findings support the carcinogenesis model in which the development of a field with genetically altered cells plays a central role. Enriching the molecular definition of the airway field of. The concept of oral field cancerization ofc was first described by slaughter et al. One theory states that multiple squamous cell lesions occur independently of each other due to the exposure of the oral cavity to carcinogens in at the same time leading to multiple genetic. This finding led to the field of the cancerization theory, which hypothesizes that the entire epithelial surface of upper aerodigestive tract has an increased risk for development of pre malignant lesions, because of multiple genetic abnormalities in the whole tissue region. The monoclonal theory of field cancerization necessitates the migration of transformed cells into the adjacent mucosa for the development of the neoplastic field. The concept of field cancerization was first introduced by slaughter et al. The development of locally recurrent cancer and the second primary tumors has frequently been explained by the concept of field cancerization. The molecular biology of mucosal field cancerization of. Mar 26, 2018 field cancerization theory postulates that the skin surrounding ak is also at increased risk for possible malignant transformation since it has been exposed to the same chronic uv light.
The field of cancerization theory has been tested and shown to be present in other epithelial cell malignancies, such as prostate, head and neck, colon, esophageal, and breast cancer. Patients with head and neck squamous cell carcinoma hnscc often develop multiple pre malignant lesions. Historical and theoretical developments friedemann schulz, m. Their findings of multifocal patches of premalignant disease, abnormal tissue surrounding tumors, multiple localized primary tumors, and tumor recurrence following surgical resection was suggestive of a field of dysplastic cells with malignant potential.
Updates on treatment approaches for cutaneous field cancerization. Upon completion of this activity, participants will be able to. Field directed therapies thus have the potential to address subclinical damage, reduce ak recurrence rates, and potentially reduce the risk of squamous cell. Field cancerization poses a greater challenge, as it influences the morbidity and mortality of oral cancer patients. Cancer stem cells and field cancerization of oral squamous. Loss of ecadherin mediated cell adhesion, a hallmark of epithelial mesenchymal transition emt, has been reported to be essential for epithelial cell motility in skin cancer 11.
This finding led to the field cancerization theory, which hypothesizes that the entire epithelial surface of the upper aerodigestive tract has an increased risk for the development of premalignant lesions because of multiple genetic abnormalities in the whole tissue region. Field cancerization, which is the replacement of the normal cell population by a cancerprimed cell population that may show no morphological change, is. Clinical implications and utility of field cancerization. Theory is a tool that enables us to identify a problem and to plan a means for altering the situation. The concept of field cancerization was originally hypothesized to explain observations in relation to oral cancer, and is now proposed to occur in a variety of organs, including the lung, breast, esophagus, stomach, and colon. Field cancerization theory postulates that the skin surrounding ak is also at increased risk for possible malignant transformation since it has been exposed to the same chronic uv light. Field carcinogenesis molecular oncology the constellation of locoregional changes triggered by longterm exposure of a field of tissue to a carcinogen. Cancerization definition of cancerization by medical dictionary. Field cancerization is defined as the preconditioning of an area of epithelium to tumor growth, either as the result of a clonal proliferation of mutant cells through the epithelium without. The concept of oral field cancerization ofc was first introduced by slaughter et al. Field cancerization in stomatognathic system kadashetti v.
Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. An alternative theory for the occurrence of multiple premalignant lesions has been proposed in the last decade and is based on the premise that any transforming event is rare and that the multiple lesions arise due to widespread migration of transformed. Concurrent multiple oral malignant and potentially malignant. Swiss clinical practice guidelines on field cancerization. Updates on treatment approaches for cutaneous field. Concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. Molecular evidence supporting field effect in urothelial. This process involves multiple intricate molecular events leading to the transformation of a completely normal cell into a cancer cell. Detection and monitoring of these fields may have profound implications for cancer prevention.
This finding led to the field of the cancerization theory, which hypothesizes that the. We will then focus on the occurrence of multiple foci of premalignant or malignant disease. Field cancerization involves the lateral spread of premalignant or malignant disease and contributes to the recurrence of head and neck tumors. Defining field cancerization slaughter and colleagues first proposed the concept of field cancerization in 1953 as the preconditioning of an area of epithelium to cancer growth by a carcinogenic. The field cancerization theory also emphasizes the high probability of recurrences in patients with head and neck squamous cell carcinoma. The process arises from exposure to an injurious environment, often over a lengthy period. Theories of field cancerization varies theories have been postulated to explain the occurrence of carcinomas in specific sites.
One theory states that multiple squamous cell lesions occur independently of each other due to the exposure of the oral cavity to carcinogens in at the same time leading to multiple genetic abnormalities in the entire area. Molecular mapping analysis of the field cancerization in nonsmall cell lung cancer nsclc. This paper tabulates markers of prostate field cancerization known to date and discusses their potential clinical value in the analysis of prostate biopsies, including diagnosis, monitoring progression during. Concepts in understanding oral field cancerization.
The second theory explains tumor multifocality as developing secondary to a field cancerization effect precipitated by carcinogens causing independent genetic alterations at different sites within the urothelial lining and leading to the development of multiple, genetically unrelated tumors. Each organ is made up of several different tissue types. Actinic keratoses are present in the field of cutaneous malignancies, including basal cell carcinoma, squamous cell carcinoma, and melanoma. Theory is to justify reimbursement to get funding and support need to explain what is being done and demonstrate that it works theory and research 3. Jan, 2014 potential mechanisms for field cancerization. We will then focus on the occurrence of multiple foci of premalignant or malignant disease in the upper aerodigestive tract and. The relevance of the lung field cancerization to the development of a particular subtype of nsclc i. 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.
Differential expression of hsamir221, hsamir21, hsa. Later, field cancerization involving histologic and molecular changes of neoplasms and adjacent tissue was explained. Although a cursory acquaitance with th subject of quantum field theory is helpful, the only. The swiss clinical practice guidelines on field cancerization of the skin have been developed by an expert panel of swiss dermatologyoncology physicians members of the reakt working group to guide other dermatologists in their approach to care for patients who have clinically apparent photodamage, ak lesions, or field cancerization, or who. The definition of field cancerization refers to a group of genetically altered clones of cells in multifocal patches, which are prone to the development of synchronous and metachronous tumors. This concept was already proposed in 1953 by slaughter et al. Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Mar 17, 2014 the definition of field cancerization refers to a group of genetically altered clones of cells in multifocal patches, which are prone to the development of synchronous and metachronous tumors. Discuss field cancerization in the context of actinic keratosis. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses aks. Fc may induce ca, cis or dysplasia, which can be recognized histologically. Dec 17, 2009 this finding led to the field cancerization theory, which suggests that the entire epithelial surface of the regional skin has an increased risk for the development of malignant lesions. Therefore, frequent clinical and histologic screening are mandatory for postoperatively. Here is a case report of field cancerization phenomenon.