Field change and oral cancer: new evidence for widespread carcinogenesis?
Patients with oral squamous cell carcinoma (OSCC) are at risk of developing second or multiple primary cancers as a result of field cancerization in the upper aerodigestive tract. In order to quantify the incidence of field change observable in oral mucosa, 26 consecutive new (untreated) patients presenting with a unilateral OSCC (18) or a premaligant lesion (eight) underwent 'mirror image' biopsies from clinically normal-looking mucosa at corresponding anatomical sites. A total of 15 patients (58%) demonstrated histologically abnormal tissue upon microscopic examination: six showed reactive change/cellular atypia associated with chronic irritation, seven exhibited frank dysplasia, whilst two displayed carcinoma-in-situ (CIS) or microinvasive SCC. Although not statistically significant, there was an observable trend for the lateral/ventral tongue and floor of mouth to display increased vulnerability to dysplastic change.
Department of Oral & Maxillofacial Surgery, The Dental School, University of Newcastle, Newcastle upon Tyne, UK. peter.thomson@ncl.ac.uk
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Thomson
D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D010610:Pharyngeal Neoplasms / Q000556:secondary*; D010865:Pilot Projects; D011230:Precancerous Conditions / Q000473:pathology / Q000556:secondary*; D012142:Respiratory Tract Neoplasms / Q000556:secondary*; D012907:Smoking