Review

Clinical implications and utility of field cancerization

Gabriel D Dakubo¹ , John P Jakupciak² , Mark A Birch-Machin³ and Ryan L Parr¹

¹  Genesis Genomics Inc., 310-1294 Balmoral Street, Thunder Bay, Ontario, P7B 5Z5, Canada

²  National Institute of Standards and Technology, Biochemical Science Division, Gaithersburg, MD 20899, USA

³  Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK

author email corresponding author email

Cancer Cell International 2007, 7:2doi:10.1186/1475-2867-7-2

Published:	15 March 2007

Abstract

Cancer begins with multiple cumulative epigenetic and genetic alterations that sequencially transform a cell, or a group of cells in a particular organ. The early genetic events might lead to clonal expansion of pre-neoplastic daughter cells in a particular tumor field. Subsequent genomic changes in some of these cells drive them towards the malignant phenotype. These transformed cells are diagnosed histopathologically as cancers owing to changes in cell morphology. Conceivably, a population of daughter cells with early genetic changes (without histopathology) remain in the organ, demonstrating the concept of field cancerization. With present technological advancement, including laser capture microdisection and high-throughput genomic technologies, carefully designed studies using appropriate control tissue will enable identification of important molecular signatures in these genetically transformed but histologically normal cells. Such tumor-specific biomarkers should have excellent clinical utility. This review examines the concept of field cancerization in several cancers and its possible utility in four areas of oncology; risk assessment, early cancer detection, monitoring of tumor progression and definition of tumor margins.