Division of Dermatology, Department of Internal Medicine, The University of Texas at Austin Dell Medical School, Austin, Texas.
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Am Acad Dermatol. 2020 Sep;83(3):709-717. doi: 10.1016/j.jaad.2020.03.126. Epub 2020 May 7.
Field cancerization was first described in 1953 when pathologic atypia was identified in clinically normal tissue surrounding oropharyngeal carcinomas. The discovery of mutated fields surrounding primary tumors raised the question of whether the development of subsequent tumors within the field represented recurrences or additional primary tumors. Since this initial study, field cancerization has been applied to numerous other epithelial tissues, including the skin. Cutaneous field cancerization occurs in areas exposed to chronic ultraviolet radiation, which leads to clonal proliferations of p53-mutated fields and is characterized by multifocal actinic keratoses, squamous cell carcinomas in situ, and cutaneous squamous cell carcinomas. In the first article in this continuing medical education series, we define field cancerization, review the available grading systems, and discuss the epidemiology, risk factors, and outcomes associated with this disease.
癌化域（Field cancerization）于 1953 年首次被描述，当时在口咽癌周围的临床正常组织中发现了病理异型性。在原发性肿瘤周围发现突变域后，人们提出了这样一个问题，即在该域内随后发生的肿瘤是复发还是另外的原发性肿瘤。自最初的研究以来，癌化域已被应用于许多其他上皮组织，包括皮肤。皮肤癌化域发生在暴露于慢性紫外线辐射的区域，这导致 p53 突变域的克隆增殖，其特征是多灶性光化性角化病、原位鳞状细胞癌和皮肤鳞状细胞癌。在本继续医学教育系列的第一篇文章中，我们定义了癌化域，回顾了现有的分级系统，并讨论了与该疾病相关的流行病学、风险因素和结果。
