TY - JOUR
T1 - A case-control study confirms that microsatellite assay can identify patients at risk of developing oral squamous cell carcinoma within a field of cancerization
AU - Partridge, M
AU - Pateromichelakis, S
AU - Phillips, E
AU - Emilion, G G
AU - A'Hern, R P
AU - Langdon, J D
PY - 2000/7/15
Y1 - 2000/7/15
N2 - Distinguishing true precursor lesions on the basis of clinical or histological features alone is unreliable but is important so that appropriate intervention can he instigated, Preliminary studies have shown that a microsatellite assay mag provide important new prognostic information, To build on these observations, we have performed a case-control study to establish whether we can be confident about incorporating this new information into clinical practice, We have determined the frequency of allelic imbalance (AI) within key chromosomal regions, by matching 39 cases with dysplastic oral lesions that developed a tumor on the same side of the mouth, for as many variables as possible, with controls presenting with similar lesions that did not progress to malignancy when followed for the same period. Our findings confirm that the group that developed tumor had precursor lesions that harbor AI at more loci (P = 0.002). However, no consistent patterns of AI were associated with the three grades of dysplasia: mild, moderate, and severe, One-third of the tumors developed at the same site as the dysplastic lesion and two-thirds at a different site, which revealed that the presence of these aberrations in a dysplastic lesion provided information about the risk of malignant change within a larger field. This suggests that the process of field cancerization is more widespread than previously recognized. On the basis of these findings, we advocate complete excision of all suspicious areas that show At at two or mure hey loci, regardless of the degree of dysplasia. However, because the remaining mucosa is also "at risk," these eases should also be targeted to receive dietary advice and chemoprevention, to minimize their risk of tumor formation at a distant site.
AB - Distinguishing true precursor lesions on the basis of clinical or histological features alone is unreliable but is important so that appropriate intervention can he instigated, Preliminary studies have shown that a microsatellite assay mag provide important new prognostic information, To build on these observations, we have performed a case-control study to establish whether we can be confident about incorporating this new information into clinical practice, We have determined the frequency of allelic imbalance (AI) within key chromosomal regions, by matching 39 cases with dysplastic oral lesions that developed a tumor on the same side of the mouth, for as many variables as possible, with controls presenting with similar lesions that did not progress to malignancy when followed for the same period. Our findings confirm that the group that developed tumor had precursor lesions that harbor AI at more loci (P = 0.002). However, no consistent patterns of AI were associated with the three grades of dysplasia: mild, moderate, and severe, One-third of the tumors developed at the same site as the dysplastic lesion and two-thirds at a different site, which revealed that the presence of these aberrations in a dysplastic lesion provided information about the risk of malignant change within a larger field. This suggests that the process of field cancerization is more widespread than previously recognized. On the basis of these findings, we advocate complete excision of all suspicious areas that show At at two or mure hey loci, regardless of the degree of dysplasia. However, because the remaining mucosa is also "at risk," these eases should also be targeted to receive dietary advice and chemoprevention, to minimize their risk of tumor formation at a distant site.
UR - http://www.scopus.com/inward/record.url?scp=0034660881&partnerID=8YFLogxK
M3 - Article
VL - 60
SP - 3893
EP - 3898
JO - Cancer Research
JF - Cancer Research
IS - 14
ER -
