title: Evidence for field cancerization of the prostate.
abstract: BACKGROUND
  Field cancerization, which is not yet well-characterized in the prostate, occurs when large areas of an organ or tissue surface are affected by a carcinogenic insult, resulting in the development of multi-focal independent premalignant foci and molecular lesions that precede histological change.
  
  
  METHODS
  Herein, we review the cumulative body of evidence concerning field effects in the prostate and critically evaluate the methods available for the identification and validation of field effect biomarkers. Validated biomarkers for field effects have an important role to play as surrogate endpoint biomarkers in Phase II prevention trials and as clinical predictors of cancer in men with negative biopsies.
  
  
  RESULTS
  Thus far, field effects have been identified involving nuclear morphometric changes, gene expression, protein expression, gene promoter methylation, DNA damage and angiogenesis. In addition to comparing cancer-adjacent benign tissue to more distant areas or to "supernormal" tissue from cancer-free organs, investigators can use a nested case-control design for negative biopsies that offers a number of unique advantages.
  
  
  CONCLUSIONS
  True carcinogenic field effects should be distinguished from secondary responses of the microenvironment to a developing tumor, although the latter may still lead to useful clinical prediction tools. Prostate 69: 1470-1479, 2009. (c) 2009 Wiley-Liss, Inc.
authors.affiliation: Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Nonn
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Ananthanarayanan
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gann
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D044127:Epigenesis, Genetic; D005819:Genetic Markers; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D005819:Genetic Markers