Sreedhar Gadiputi, Narayanappa Sumalatha Masineni, Shukla Deepika
Department of Oral Pathology and Microbiology, Babu Banarasi Das College of Dental Sciences, Lucknow, India.
Department of Oral Medicine, Babu Banarasi Das College of Dental Sciences, Lucknow, India.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015 Jun;159(2):178-83. doi: 10.5507/bp.2013.092. Epub 2014 Jan 3.
Field cancerization is a well-known and well-documented process of malignant transformation first coined by Slaughter et al. in 1953. Tobacco chewing was associated with the greatest increase in the risk of multiple oral premalignant lesions and may be the major source of field cancerization of the oral cavity in the Indian population. The field cancerization will probably help clinicians in complementing evaluation of pathologic biopsy specimens.
We present a case report of field cancerization in a 63-year-old Indian female. She presented with an intra-oral generalized hyperkeratotic verruciform type white lesions involving right and left buccal mucosa, lower labial mucosa, upper and lower vestibule, dorsal, ventral and right lateral border of the tongue, hard and soft palate. Microscopic examination revealed features of verrucous carcinoma in one area, squamous cell carcinoma in another and carcinoma in situ in other areas. Based on the overall features in various areas of the oral cavity, the lesion was diagnosed as field cancerization.
Reviewing the literature revealed the presence of a field with genetically altered cells appear to be induced by tobacco (smoking/smokeless form). The large number of premalignant cells in the fields may increase cancer risk considerably. Thus screening and monitoring of the field may have serious implications for oral cancer prevention.
场癌化是一种广为人知且有充分文献记载的恶性转化过程，最早由斯劳特等人于1953年提出。嚼烟与多种口腔癌前病变风险的最大增加有关，可能是印度人群口腔场癌化的主要来源。场癌化可能有助于临床医生补充对病理活检标本的评估。
我们报告一例63岁印度女性的场癌化病例。她口腔内出现广泛性角化过度的疣状白色病变，累及左右颊黏膜、下唇黏膜、上下前庭、舌背、舌腹及右侧边缘、硬腭和软腭。显微镜检查显示一个区域有疣状癌特征，另一个区域有鳞状细胞癌特征，其他区域有原位癌特征。根据口腔各区域的总体特征，该病变被诊断为场癌化。
回顾文献发现，存在一个似乎由烟草（吸烟/无烟形式）诱导的基因改变细胞区域。该区域中大量的癌前细胞可能会显著增加患癌风险。因此，对该区域的筛查和监测可能对口腔癌预防具有重要意义。
