Field cancerization in mammary carcinogenesis implications. Jul 19, 2019 field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Volume 103, issues 23, februarymarch 2014, pages 211221. Field cancerization therapy with ingenol mebutate contributes to. 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. The authors hypothesize hh as a possible expression of cf. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses aks. Evidence for field effect cancerization in colorectal cancer. The clinical concept of field cancerization originally proposed by slaughter and. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors.
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. Updates on treatment approaches for cutaneous field cancerization. An expanded preneoplastic field surrounding lesions may appear histologically normal or nondysplastic but harbor cancerassociated molecular and cellular changes. 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. Most field changes appear to be induced by smoking, which implies carcinogeninduced field cancerization rather than field cancerization due to migrated transformed cells. Field cancerization, or a field effect, has been documented in eac and many other types of cancer 68. Mar 17, 2014 concepts of field cancerization based on clonality models. Carcinogenesis and field cancerization in oral squamous. The concept of field cancerization was introduced by slaughter in 1953, through the study of multicentric oral mucosa neoplasms. 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.
Clinical implications and utility of field cancerization. The concept of field cancerization describes the tendency of patients with premalignant and. 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. View the article pdf and any associated supplements and figures for a period of 48 hours. Pdf concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. Detecting field cancerization using a hyperspectral.
These processes may explain the phenomenon of field cancerization, i. The concept of field cancerization was first proposed in 1953 by slaughter et al 1 in their study of oral squamous carcinomas. Field cancerization is probably a general phenomenon of epithelial tumors. Since the first description of field cancerization, this concept has been applied to cancers in many different tissues chai and brown, 2009. 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.
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. The presence of a field with genetically altered cells is a risk factor for cancer. 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. Jan 19, 2017 cancerassociated fibroblasts enact field cancerization by promoting extratumoral oxidative stress. This process involves multiple intricate molecular events leading to the transformation of a completely normal. Field cancerization was first described in oral cancers. These patients can also be affected by multiple primary cancers arising out of the affected atrisk tissue, either concurrently or with an interval.
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. 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. Mar 15, 2007 such tumorspecific biomarkers should have excellent clinical utility. The concept of field effect cancerization was first proposed by slaughter et al.
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. The hamster cheek pouch model for field cancerization studies. 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. In normal oral and laryngeal epithelium, type 2 chain abhantigens are expressed on parabasal cells. Cancer stem cells and field cancerization of oral squamous. 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.
The term field cancerization was first put forward by slaughter et al. 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. 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. 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. Molecular genetic studies conducted in the headandneck tumors to explain the. Swiss clinical practice guidelines on field cancerization. The process arises from exposure to an injurious environment, often over a lengthy period. We also conclude that almost no remote multiple tumors develop due to migration of tumor cells. Ploidy analysis of field cancerization and cancer development in the hamster cheek pouch carcinogenesis model. Aberrant dna methylation has been identified as a potential biomarker for field cancerization defects in the colon. Molecular mapping analysis of the field cancerization in nonsmall cell lung cancer nsclc. Updates on treatment approaches for cutaneous field. Although the concept of field cancerization was proposed almost 60 years ago, our understanding of many fundamental aspects of this phenomenon is still rudimentary.
Active telethermography att allows us to observe the imaging of a hyperthermic halo hh surrounding the tumor. Hence, the field from which cancerous lesions emerge might reflect a field of exposure or a field of genetic predisposition. 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 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. Jan, 2014 potential mechanisms for field cancerization. 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. An expansion to the definition of field cancerization has recently. The relevance of the lung field cancerization to the development of a particular subtype of nsclc i. Introduction oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon but. Field cancerization and metastasis are the leading causes for cancer recurrence and mortality in cancer patients. Oral field cancerization is a process of malignant transformation. Field cancerization definition of field cancerization by. Cancer stem cell markers aldh1 and bmi1 expression in oral.
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. Cancerassociated fibroblasts enact field cancerization by promoting extratumoral oxidative stress. 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. Field cancerization, microsatellite markers, monoclonality, polyclonality. Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. Carcinogenesis and field cancerization in oral squamous cell. 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.
This explains the higher recurrence rates following tumor resections. Concept of field cancerization was first introduced over six decades ago in the setting of oral cancer. Field cancerization involves the lateral spread of premalignant or malignant disease and contributes to the recurrence of head and neck tumors. It was proposed to explain the development of multiple primary tumors and locally recurrent cancer. These spreading alterations in both the epithelium and stroma are a phenomenon known as field cancerization. Oral field cancerization theory given by slaughter and colleagues 1953 which hypothesized that the. Recent advances in field cancerization and management. Field cancerization therapies for management of actinic. This field cancerization concept is well established in a variety of. Cancerassociated fibroblasts enact field cancerization by. The efficacy of these histochemical techniques as biomarkers of early cancerization must be demonstrated in appropriate models. 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 is the presence of transformed cells adjacent to the primary tumor, and it is. 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.
Mutations in keratinocyte and melanocyte precursors that are caused by extensive sun exposure are wellestablished contributors to skin cancer. Pdf there always exists a field with genetically altered cells with a high risk. Defining field cancerization slaughter and colleagues first proposed the concept of field cancerization in 1953 as the preconditioning of an area of epithelium to. 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. The mouse hf left image is composed of at least four different ksc populations.
Field cancerization an overview sciencedirect topics. Clinical implications and utility of field cancerization cancer cell. The concept of field cancerization was first introduced by slaughter et al. Oral field cancerization occurs by either cell migration or development from independent cells.
This theory has been used to describe the occurrence of primary tumors at multiple sites and recurrences following complete excision. Interestingly, a model of field cancerization orchestrated by the cancer stem cells csc was proposed and suggested the identification of csc. Integrating the concept of field cancerization in the classification and risk assessment of cutaneous squamous cell carcinoma. 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. Hpv8 field cancerization in a transgenic mouse model is. Fc may induce ca, cis or dysplasia, which can be recognized histologically. Field cancerization in oral lichen planus sciencedirect. Field cancerization poses a greater challenge, as it influences the morbidity and mortality of oral cancer patients. 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. Oral field cancerization and its clinical implications in the. The large number of preneoplastic cells in the proliferating fields is likely to increase cancer risk dramatically.
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. Multifocal epithelial tumors and field cancerization. Concepts of field cancerization based on clonality models oral field cancerization occurs by either cell migration or development from independent cells. Field cancerization also called field defect or field effect is a wellknown process of transformation of an existing precancerous lesion into a malignancy. Jci multifocal epithelial tumors and field cancerization. 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. Such tumorspecific biomarkers should have excellent clinical utility. Background field cancerization denotes subclinical abnormalities in a tissue chronically exposed to uv radiation. Field cancerization in mammary carcinogenesis implications for. There always exists a field with genetically altered cells with a high risk of developing premalignant and malignant lesions. Actinic keratosis as a marker of field cancerization in. Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Klein a, karrer s, horner c, werner a, heinlin j, zeman f, et al. 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.
767 564 1216 197 826 1005 1030 267 1513 642 1578 350 669 343 1373 238 158 1001 1284 972 1244 833 1332 832 450 300 209 812 1017 317 83 1504 295 259 1359 182 1372 733 823 1166 88 195