State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan, China.
Med Hypotheses. 2010 Jul;75(1):26-31. doi: 10.1016/j.mehy.2010.01.019. Epub 2010 Feb 9.
The common oral diseases as well as oral cancer have the characteristic of field cancerization or field effect. Field cancerization, characterized by phenotypic and genetic changes in the neighboring cells of the frank cancer cells, is a clinical phenomenon first found in head and neck cancers. Field cancerization of the epithelia is currently a widely-accepted model in cancer biology as a manifestation of cancer progression. The concomitant changes in the tumor microenvironment have drawn more attention recently. Could the changes in the tumor microenvironment and the epithelial field cancerization concepts be linked? In view of the importance of stroma in the development of epithelium and evidence in carcinoma-associated stroma, we propose the question if stroma not only reciprocates the neoplastic changes of the epithelia, but also contributes to field cancerization. Actually one perspective paper pointed out that healing wound can influence the recurrence of field cancerization. In another words, the microenvironment of healing wound determines the prognosis of field cancerization. Based on the literatures published and our own work, we hypothesize a new model of field cancerization focusing on the co-evolution of the tumor microenvironment. We suggest that the microenvironment cannot be neglected when treating diseases with characteristics of field cancerization.
常见的口腔疾病以及口腔癌具有“癌化域”或“场效应”的特征。“癌化域”的特征是在癌症细胞的临近细胞中出现表型和遗传改变，这是首先在头颈部癌症中发现的一种临床现象。上皮细胞的“癌化域”目前是癌症生物学中被广泛接受的一个模型，是癌症进展的一种表现。最近，肿瘤微环境的伴随变化引起了更多的关注。肿瘤微环境的变化和上皮“癌化域”的概念是否可以联系起来？鉴于基质在上皮发育中的重要性以及癌相关基质中的证据，我们提出了一个问题，即基质是否不仅会对上皮的肿瘤性变化产生反作用，而且还会促进“癌化域”的形成。实际上，有一篇观点文章指出，愈合的伤口可以影响“癌化域”的复发。换句话说，愈合伤口的微环境决定了“癌化域”的预后。基于已发表的文献和我们自己的工作，我们提出了一个关注肿瘤微环境共同进化的“癌化域”新模型。我们建议，在治疗具有“癌化域”特征的疾病时，不能忽视微环境。
