Field cancerization, either cutaneous or in other organs may be defined in molecular terms, in which the presence of mutated cells forms the groundwork that permits the progression of epithelial carcinogenesis with its relevant clinical consequences. Such tumorspecific biomarkers should have excellent clinical utility. Cancer stem cells and field cancerization of oral squamous. The large number of preneoplastic cells in the proliferating fields is likely to increase cancer risk dramatically. The process arises from exposure to an injurious environment, often over a lengthy period. Aberrant dna methylation has been identified as a potential biomarker for field cancerization defects in the colon.
These processes may explain the phenomenon of field cancerization, i. Comparing coldair analgesia, systemically administered analgesia and scalp nerve blocks for pain management during photodynamic therapy for actinic keratosis of the scalp presenting as field cancerization. The concept of field effect cancerization was first proposed by slaughter et al. Actinic keratosis as a marker of field cancerization in. The concept of field cancerization was introduced by slaughter in 1953, through the study of multicentric oral mucosa neoplasms. This theory has been used to describe the occurrence of primary tumors at multiple sites and recurrences following complete excision. Field cancerization involves the lateral spread of premalignant or malignant disease and contributes to the recurrence of head and neck tumors. A genetic explanation of slaughters concept of field. 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. Mar 30, 2019 field cancerization and metastasis are the leading causes for cancer recurrence and mortality in cancer patients. There always exists a field with genetically altered cells with a high risk of developing premalignant and malignant lesions. Active telethermography att allows us to observe the imaging of a hyperthermic halo hh surrounding the tumor.
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. Integrating the concept of field cancerization in the classification and risk assessment of cutaneous squamous cell carcinoma. The field cancerization concept, originally proposed over 60 years ago, hypothesized that multiple primary cancers may arise simultaneously and coexist with subclinical precursor lesions within a defined field. Updates on treatment approaches for cutaneous field.
Concepts of field cancerization based on clonality models oral field cancerization occurs by either cell migration or development from independent cells. Field cancerization is the presence of transformed cells adjacent to the primary tumor, and it is. 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. The formation of primary, secondary tumors or metastasis is greatly influenced by multifaceted tumorstroma interactions, in which stromal components of the tumor microenvironment tme can affect the behavior of the cancer cells. Mar 17, 2014 concepts of field cancerization based on clonality models. Background field cancerization denotes subclinical abnormalities in a tissue chronically exposed to uv radiation. The concept of field cancerization was first introduced by slaughter et al. Pdf there always exists a field with genetically altered cells with a high risk. We also conclude that almost no remote multiple tumors develop due to migration of tumor cells. There is limited direct evidence to show that systemic acitretin or nicotinamide can decrease incident scc in patients with field cancerization. Oral field cancerization and its clinical implications in the.
Klein a, karrer s, horner c, werner a, heinlin j, zeman f, et al. Recent advances in field cancerization and management. Most field changes appear to be induced by smoking, which implies carcinogeninduced field cancerization rather than field cancerization due to migrated transformed cells. Swiss clinical practice guidelines on field cancerization of.
Multifocal epithelial tumors and field cancerization. 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. Field cancerization is probably a general phenomenon of epithelial tumors. If multiple tumors occur from the migration of cells from their primary source, the genetic alterations of the primary cell are carried over to all the progenitor cells. Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. Integrating the concept of field cancerization in the. The mechanisms that drive these processes are poorly understood, but evidence from the literature suggests that mammary carcinogenesis may occur through the process of field cancerization.
Concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. Cancer stem cell markers aldh1 and bmi1 expression in oral. Field cancerization is the process in which a singular cell accumulates genetic mutations following carcinogen exposure and then divides to create a field of monoclonal premalignant cells. Oral field cancerization occurs by either cell migration or development from independent cells. These spreading alterations in both the epithelium and stroma are a phenomenon known as field cancerization. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors. Jan, 2014 although the concept of field cancerization was proposed almost 60 years ago, our understanding of many fundamental aspects of this phenomenon is still rudimentary. Cancer stem cell driven field cancerization a model the process of field cancerization is initiated by the carcinogen assault leading to an alteration p53p16fhit in the stem cell residing in the normal epithelium. Hpv8 field cancerization in a transgenic mouse model is. Pdf concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. A 4fold lower expression of type 2 chain abhantigen was shown in exfoliated cells from macroscopically normal mucosa from six different places distant from the hnscc, compared with healthy.
Clinical implications and utility of field cancerization cancer cell. An expansion to the definition of field cancerization has recently. Field cancerization could initiate from a stem cell that acquires a genetic or epigenetic alteration, which induces proliferation and expansion of the stem celllike population. Gerhard w goerres, daniel t schmid, florian bandhauer, pia u. Swiss clinical practice guidelines on field cancerization. This process involves multiple intricate molecular events leading to the transformation of a completely normal. Clinical implications and utility of field cancerization. Oral field cancerization is a process of malignant transformation.
Field carcinogenesis molecular oncology the constellation of locoregional changes triggered by longterm exposure of a field of tissue to a carcinogen. A 4fold lower expression of type 2 chain abhantigen was shown in exfoliated cells from macroscopically normal mucosa from six different places distant from the hnscc, compared with healthy individuals. The concept of field cancerization was first proposed in 1953 by slaughter et al 1 in their study of oral squamous carcinomas. 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. Field cancerization was first described in oral cancers. Field cancerization, microsatellite markers, monoclonality, polyclonality. Hence, the field from which cancerous lesions emerge might reflect a field of exposure or a field of genetic predisposition. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file. Jci multifocal epithelial tumors and field cancerization. Aug 19, 2015 at skin level, a cancerization field cf indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present. Later, field cancerization involving histologic and molecular changes of neoplasms and adjacent. Field cancerization an overview sciencedirect topics. In this study, microscopically identified actinic keratoses aks were used as markers of field cancerization in all excision specimens of squamous cell carcinomas sccs, basal cell carcinomas bccs.
Mutations in keratinocyte and melanocyte precursors that are caused by extensive sun exposure are wellestablished contributors to skin cancer. Defining field cancerization slaughter and colleagues first proposed the concept of field cancerization in 1953 as the preconditioning of an area of epithelium to. 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 hamster cheek pouch model for field cancerization studies. Field cancerization, or a field effect, has been documented in eac and many other types of cancer 68. It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. Cancerassociated fibroblasts enact field cancerization by promoting extratumoral oxidative stress.
Field cancerization therapies for management of actinic. 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. Carcinogenesis and field cancerization in oral squamous cell. The concept of field cancerization describes the tendency of patients with premalignant and. Field cancerization therapy with ingenol mebutate contributes to. Volume 103, issues 23, februarymarch 2014, pages 211221. Interestingly, a model of field cancerization orchestrated by the cancer stem cells csc was proposed and suggested the identification of csc. Field cancerization poses a greater challenge, as it influences the morbidity and mortality of oral cancer patients. Field cancerization is a phenomenon in which prolonged exposure to carcinogens induces changes throughout the epithelium leaving the field ready for the appearance of premalignant or malignant lesions. Field cancerization also called field defect or field effect is a wellknown process of transformation of an existing precancerous lesion into a malignancy. Cancerassociated fibroblasts enact field cancerization by.
Molecular mapping analysis of the field cancerization in nonsmall cell lung cancer nsclc. The term field cancerization was first put forward by slaughter et al. 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. Jul 19, 2019 field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Apr 05, 2020 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 presence of a field with genetically altered cells is a risk factor for cancer. This explains the higher recurrence rates following tumor resections. Molecular genetic studies conducted in the headandneck tumors to explain the. Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli.
Updates on treatment approaches for cutaneous field cancerization. The authors hypothesize hh as a possible expression of cf. Field cancerization in mammary carcinogenesis implications for. The efficacy of these histochemical techniques as biomarkers of early cancerization must be demonstrated in appropriate models. Introduction oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon but. 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. Oral field cancerization theory given by slaughter and colleagues 1953 which hypothesized that the. Detecting field cancerization using a hyperspectral. Field cancerization in mammary carcinogenesis implications. In normal oral and laryngeal epithelium, type 2 chain abhantigens are expressed on parabasal cells. Field cancerization and metastasis are the leading causes for cancer recurrence and mortality in cancer patients. The clinical concept of field cancerization originally proposed by slaughter and. 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. Field cancerization is a biological process in which large areas of cells at a tissue surface or.
The natural history of breast cancer unfolds with the development of ductal carcinoma in situ dcis in normal breast tissue, and evolution of this preinvasive neoplasm into invasive cancer. Field cancerization was first proposed to account for the multiple cancers that develop in cigarette smokers within the carcinogenexposed field that comprises the aerodigestive tract slaughter et al. Field cancerization definition of field cancerization by. At skin level, a cancerization field cf indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present. Mar 15, 2007 such tumorspecific biomarkers should have excellent clinical utility. 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. Ploidy analysis of field cancerization and cancer development in the hamster cheek pouch carcinogenesis model.
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. Jan, 2014 potential mechanisms for field cancerization. This field cancerization concept is well established in a variety of. Although the concept of field cancerization was proposed almost 60 years ago, our understanding of many fundamental aspects of this phenomenon is still rudimentary. Carcinogenesis and field cancerization in oral squamous. The hamster cheek pouch oral cancer model, universally employed in biological studies and in studies for the prevention and treatment of oral cancer, is also an excellent model of field cancerization. These patients can also be affected by multiple primary cancers arising out of the affected atrisk tissue, either concurrently or with an interval.
1052 1261 850 598 1287 557 1517 1596 1158 947 589 1186 1044 42 551 1508 830 488 266 66 294 112 486 452 1295 817 73 970 27 140 813 728 169