title: Current understanding of the tumor microenvironment of laryngeal dysplasia and progression to invasive cancer.
abstract: OBJECTIVE
  This review examines the historical tumor progression genetic model of laryngeal carcinomas, from dysplasia to invasive carcinoma and the role of infiltrating immune and inflammatory cells as contributors to this process.
  
  
  RESULTS
  Classically, the genetic model of carcinogenesis describes overexpression of oncogenes and/or silencing of tumor suppressor genes which, when combined with exposure to environmental carcinogens over the course of time, results in damage to cellular DNA. Increasing evidence indicates that innate and adaptive immune mediators also play an important role in tumor progression of laryngeal carcinomas. Cellular mediators of immune suppression are often over represented in the tumor microenvironment and these cells release cytokines, which perpetuate immune suppression allowing for tumor immune evasion.
  
  
  CONCLUSIONS
  Future therapies targeting laryngeal malignancies should focus on a combined approach which targets both genetic variations and immune mediators.
authors.affiliation: aDepartment of OtolaryngologybDepartment of Immunology, University of Pittsburgh School of MedicinecCancer Immunology ProgramdTumor Microenvironment Center, University of Pittsburgh Cancer Institute, Pittsburgh, USA.
authors.forename: Sumita
authors.initials: S
authors.lastname: Trivedi
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D002471:Cell Transformation, Neoplastic / Q000235:genetics* / Q000276:immunology*; D018450:Disease Progression; D006801:Humans; D007822:Laryngeal Neoplasms / Q000235:genetics* / Q000276:immunology*; D059016:Tumor Microenvironment / Q000235:genetics* / Q000276:immunology*