Fields and field cancerization: the preneoplastic origins of cancer: asymptomatic hyperplastic fields are precursors of neoplasia, and their progression to tumors can …

H Rubin - Bioessays, 2011 - Wiley Online Library
H Rubin
Bioessays, 2011Wiley Online Library
Most basic research on cancer concerns genetic changes in benign and malignant tumors.
Yet evidence indicates that the majority of the mutations in tumors occur in the preneoplastic
field stage of their development. That early stage is represented by grossly invisible, broad
regions of “field cancerization” which have not, heretofore, been operationally analyzed in
cell culture. Conditions are described for quantitating preneoplasia by increased saturation
density followed by progression to transformation. These parameters are driven by …
Abstract
Most basic research on cancer concerns genetic changes in benign and malignant tumors. Yet evidence indicates that the majority of the mutations in tumors occur in the preneoplastic field stage of their development. That early stage is represented by grossly invisible, broad regions of “field cancerization” which have not, heretofore, been operationally analyzed in cell culture. Conditions are described for quantitating preneoplasia by increased saturation density followed by progression to transformation. These parameters are driven by Darwinian selection of spontaneously occurring, cumulative mutations, in accordance with recent genomic analyses of human cancer, just as it is in the evolution of species. The cell culture model will allow correlation of the preneoplastic increases in saturation density with genetic changes, and development of methods for demarcating fields during surgery so that they can be excised along with the tumor, thereby reducing the possibility of recurrence at the site.
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