Novel management of oral cancer: a paradigm of predictive oncology.
Novel management of oral cancer: a paradigm of predictive oncology.
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DOI：
10.3121/cmr.2.4.233
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发表时间：
2004-11
影响因子：
1.4
通讯作者：
J. Sudbø
中科院分区：
文献类型：
--
作者：
J. Sudbø
口腔癌的分子靶向预防的基本原理是强有力的。口腔癌是全球公共卫生的主要威胁，全球每年诊断出30万例新病例。值得注意的是，这种毁灭性疾病的高发病率和死亡率几十年来没有改善。口腔癌的发生是一个与烟草相关的多步骤、多灶性过程，涉及到田间致癌和上皮内克隆扩散。基因组不稳定性的生物标志物，如非整倍体和等位基因失衡，可以准确地测量口腔癌前病变或上皮内瘤变（IEN）的癌症风险。类维生素A口服肠内营养研究（例如，维甲酸受体-β、p53、遗传不稳定性、杂合性丢失和细胞周期蛋白D1）的研究促进了对上皮内癌变生物学和预防剂分子机制和靶点的全面理解，对监测预防干预、评估癌症风险和药物基因组学的重要进展。虽然完全切除不能预防高危患者的口腔癌，但口腔内肠内营养的临床管理从观察等待到完全切除各不相同。迫切需要新的方法，如分子靶向药物和药物组合干预分子定义的高风险口腔内分泌干扰症患者，以减少口腔癌的破坏性全球后果。
The rationale for molecular-targeted prevention of oral cancer is strong. Oral cancer is a major global threat to public health with 300,000 new cases diagnosed worldwide on an annual basis. Notably, the great morbidity and mortality rates of this devastating disease have not improved in decades. Oral cancer development is a tobacco-related multistep and multifocal process involving field carcinogenesis and intraepithelial clonal spread. Biomarkers of genomic instability, such as aneuploidy and allelic imbalance, can accurately measure the cancer risk of oral premalignant lesions or intraepithelial neoplasia (IEN). Retinoid-oral IEN studies (e.g., retinoid acid receptor-beta, p53, genetic instability, loss of heterozygosity, and cyclin D1) have advanced the overall understanding of the biology of intraepithelial carcinogenesis and preventive agent molecular mechanisms and targets, important advances for monitoring preventive interventions, assessing cancer risk, and pharmacogenomics. Clinical management of oral IEN varies from watchful waiting to complete resection, although complete resection does not prevent oral cancer in high-risk patients. New approaches, such as interventions with molecular-targeted agents and agent combinations in molecularly defined high-risk oral IEN patients, are urgently needed to reduce the devastating worldwide consequences of oral cancer.