A new paradigm in the way we envision tissue change during carcinogenesis has evolved in recent years. From a clinical standpoint, this paradigm has altered how we view “at-risk” tissue. Rather than focusing on clinical lesions, we often discuss “field” changes involving the expansion of genetically and epigenetically altered cells within a tissue, and not necessarily centered on a clinically identifiable lesion. This change reflects the recognition that genetically altered fields of cells are not always clinically or histologically apparent, yet even when occult, can constitute a significant risk. This shift in perspective has caused a management conundrum. We can use molecular techniques to characterize field changes in an extremely detailed fashion; however, such evaluation depends on identifying areas for its use.
Autori
Catherine F. Poh 1-2-4
Calum E. MacAulay 3
Lewei Zhang 1-4
Miriam P. Rosin 2-5
1Faculty of Dentistry, University of British Columbia,
2Cancer Control Research,
3Department of Cancer Imaging, British Columbia Cancer Agency Research Centre
4Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada
5Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada