%0 Journal Article
%T Markers of Field Cancerization: Proposed Clinical Applications in Prostate Biopsies
%A Kristina A. Trujillo
%A Anna C. Jones
%A Jeffrey K. Griffith
%A Marco Bisoffi
%J Prostate Cancer
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/302894
%X Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. This paper tabulates markers of prostate field cancerization known to date and discusses their potential clinical value in the analysis of prostate biopsies, including diagnosis, monitoring progression during active surveillance, and assessing efficacy of presurgical neoadjuvant and focal therapeutic interventions. 1. Introduction 1.1. Definitions of Field Cancerization The term ¡°field cancerization¡± or ¡°field effect¡± was originally introduced by Dr. Slaughter and colleagues in 1953 in the context of oral squamous cell carcinoma [1]. It was used to describe the presence of histologically abnormal tissue surrounding primary cancerous lesions and was proposed to be the reason for the occurrence of multifocal tumors and for the development of locally recurrent cancer. Field cancerization was much later proposed for other organ systems, including prostate [2¨C7]. While its original clinical implication remained the same, that is, the occurrence of multifocality and cancer recurrence, it must be emphasized that the definition of field cancerization has changed over time. Of note, due to the tremendous progress in molecular biology and biotechnology since the 1950s, the description of field cancerization has changed from a largely histological to a more refined molecular perspective. This change is perhaps best reflected in the following definitions reported in the literature. Accordingly, the original intention by Slaughter and colleagues [1] was to describe: ¡°The presence of histologically abnormal tissue surrounding cancerous lesions.¡± H£¿ckel and Dornh£¿fer extended this definition by using the term ¡°hydra phenomenon of cancer¡± [8]: ¡°The monoclonal or multiclonal displacement of normal epithelium by a genetically altered but microscopically undistinguishable homologue.¡± In addition to the transition from a purely histological to a molecular description, another notable change is the introduction of the concept of histological normalcy as part of tissue pre-malignancy. Indeed, this newer definition is now established for organs developing solid tumors, including prostate cancer, and denotes the occurrence of molecular alterations in structurally intact cells that are part of histologically normal tissues. Several aspects of prostate field cancerization remain unanswered. An immediate question is whether the ¡°field¡± of molecular alterations is exclusively of precursor nature,
%U http://www.hindawi.com/journals/pc/2012/302894/