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Archives of Pathology & Laboratory... Dec 2017- The identification of precursor or dysplastic lesions in the thyroid is difficult. Pathology of the C cell has been extensively studied, and the preneoplastic nature... (Review)
Review
CONTEXT
- The identification of precursor or dysplastic lesions in the thyroid is difficult. Pathology of the C cell has been extensively studied, and the preneoplastic nature of C-cell hyperplasia in the setting of familial medullary thyroid carcinomas is well established. However, the distinction between neoplastic and physiologic/reactive C-cell hyperplasia remains a challenge. Unlike C cells, the existence of a precursor lesion of follicular cell-derived tumors is less well established, and a dysplastic or preneoplastic follicular lesion has not been well defined.
OBJECTIVE
- To discuss putative precursor lesions in the thyroid arising from C cells and follicular epithelial cells.
DATA SOURCES
- Data were obtained from a review of the pertinent peer-reviewed literature.
CONCLUSIONS
- Although the preneoplastic nature of C-cell hyperplasia in the setting of familial medullary thyroid carcinoma is well recognized, the preneoplastic nature/malignant potential of reactive/physiologic C-cell hyperplasia and its role in the development of sporadic, medullary thyroid carcinoma is still unclear. Current data suggest that benign follicular lesions may have malignant potential, and there may be a multifocal progression from benign to malignant. Atypical follicular lesions in the background of chronic lymphocytic thyroiditis may represent dysplastic or premalignant lesions.
Topics: Biomarkers, Tumor; Carcinoma, Medullary; Carcinoma, Neuroendocrine; Diagnosis, Differential; Epithelial Cells; Humans; Hyperplasia; Multiple Endocrine Neoplasia Type 2a; Mutation; Precancerous Conditions; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms
PubMed: 28644684
DOI: 10.5858/arpa.2016-0399-RA -
Proceedings of the National Academy of... Sep 2016Prevention is an essential component of cancer eradication. Next-generation sequencing of cancer genomes and epigenomes has defined large numbers of driver mutations and...
Prevention is an essential component of cancer eradication. Next-generation sequencing of cancer genomes and epigenomes has defined large numbers of driver mutations and molecular subgroups, leading to therapeutic advances. By comparison, there is a relative paucity of such knowledge in premalignant neoplasia, which inherently limits the potential to develop precision prevention strategies. Studies on the interplay between germ-line and somatic events have elucidated genetic processes underlying premalignant progression and preventive targets. Emerging data hint at the immune system's ability to intercept premalignancy and prevent cancer. Genetically engineered mouse models have identified mechanisms by which genetic drivers and other somatic alterations recruit inflammatory cells and induce changes in normal cells to create and interact with the premalignant tumor microenvironment to promote oncogenesis and immune evasion. These studies are currently limited to only a few lesion types and patients. In this Perspective, we advocate a large-scale collaborative effort to systematically map the biology of premalignancy and the surrounding cellular response. By bringing together scientists from diverse disciplines (e.g., biochemistry, omics, and computational biology; microbiology, immunology, and medical genetics; engineering, imaging, and synthetic chemistry; and implementation science), we can drive a concerted effort focused on cancer vaccines to reprogram the immune response to prevent, detect, and reject premalignancy. Lynch syndrome, clonal hematopoiesis, and cervical intraepithelial neoplasia which also serve as models for inherited syndromes, blood, and viral premalignancies, are ideal scenarios in which to launch this initiative.
Topics: Germ Cells; Humans; Immune System; Models, Biological; Neoplasm Proteins; Neoplasms; Precancerous Conditions; Tumor Microenvironment
PubMed: 27638202
DOI: 10.1073/pnas.1608077113 -
Archives of Pathology & Laboratory... Oct 2011Barrett esophagus is a metaplastic, premalignant lesion associated with approximately 0.5% annual incidence of progression to esophageal adenocarcinoma. Diagnosis and... (Review)
Review
CONTEXT
Barrett esophagus is a metaplastic, premalignant lesion associated with approximately 0.5% annual incidence of progression to esophageal adenocarcinoma. Diagnosis and screening of Barrett esophagus and Barrett-related dysplasia relies on histologic evaluation of endoscopic mucosal biopsies, a process that is burdened with interobserver variability.
OBJECTIVES
To review the histologic features and classification of Barrett esophagus and Barrett-related dysplasia, to discuss the underlying difficulties in diagnosis and pitfalls, and to provide a brief review of new developments related to therapeutic modalities for patients diagnosed with dysplasia.
DATA SOURCES
Sources include a review of relevant literature indexed in PubMed (US National Library of Medicine).
CONCLUSIONS
In spite of interobserver variability, histologic assessment of dysplasia is currently the accepted method of surveillance, and subsequent patient management is dictated by this evaluation. Although not universal, endoscopic therapy is increasingly important in replacing esophagectomy for patients with high-grade dysplasia or early carcinoma.
Topics: Adenocarcinoma; Barrett Esophagus; Disease Progression; Esophageal Neoplasms; Esophagoscopy; Gastroesophageal Reflux; Humans; Immunohistochemistry; Metaplasia; Precancerous Conditions; Risk Factors
PubMed: 21970480
DOI: 10.5858/arpa.2011-0019-RA -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2009We grouped as oral lichenoid disease (OLD) a series of chronic inflammatory processes with autoimmune base that affect the epithelium of the oral mucosa. This disease... (Review)
Review
We grouped as oral lichenoid disease (OLD) a series of chronic inflammatory processes with autoimmune base that affect the epithelium of the oral mucosa. This disease presents in 2% of the population with a marked predilection for the female gender, especially perimenopausal women. Clinically, it is characterized by the presence of lineal reticular papules and histologically by liquefaction degeneration of the basal layer of the epithelium associated with an inflammatory infiltrate with a "band-like" disposition on the lamina propria, composed primarily of T lymphocyte cells. Its pathogenicity is associated with deregulation of the cellular immune system, where the activated cytotoxic CD8 and the CD4 T helper lymphocytes induce apoptosis of the epithelial cells. Classically it has been considered a precancerous condition, although the malignant transformation does not exceed 1% of cases. In recent years the differentiation between oral lichen planus (OLP) and oral lichenoid lesions (OLL) has become important, since the latter might have a greater malignant potential. In this paper, we analyse and update some controversial aspects of this frequent oral disease in relation to the diagnosis and malignant potential.
Topics: Humans; Lichen Planus, Oral; Precancerous Conditions; Prognosis
PubMed: 19242390
DOI: No ID Found -
Revue Medicale de Liege Aug 2002Barrett's oesophagus (BE) is a segment of columnar lined epithelium in the distal oesophagus, above the gastrooesophageal junction. So it is important to localize this... (Review)
Review
Barrett's oesophagus (BE) is a segment of columnar lined epithelium in the distal oesophagus, above the gastrooesophageal junction. So it is important to localize this junction endoscopically; the proximal margin of the gastric folds is the anatomic landmark. Another important feature of BE is the specialized intestinal metaplasia. In the aetiology of this condition, acid reflux is a primary event but there is evidence that other factors are causal. As BE is a well known premalignant condition, detection of dysplastic epithelium and its severity is the crucial element. Practical guidelines are presented for endoscopic surveillance program. The purpose is the early detection of high grade dysplasia and carcinoma to advise oesophagectomy or endoscopic ablation therapy for patients unfit to undergo surgery.
Topics: Algorithms; Barrett Esophagus; Catheter Ablation; Decision Trees; Disease Progression; Esophagectomy; Esophagoscopy; Gastroesophageal Reflux; Humans; Incidence; Practice Guidelines as Topic; Precancerous Conditions; Prognosis; Risk Factors
PubMed: 12405027
DOI: No ID Found -
Leukemia & Lymphoma Dec 2010Multiple myeloma (MM) is a malignant plasma cell dyscrasia localized in the bone marrow. Recent studies have shown that MM is preceded in virtually all cases by a... (Review)
Review
Multiple myeloma (MM) is a malignant plasma cell dyscrasia localized in the bone marrow. Recent studies have shown that MM is preceded in virtually all cases by a premalignant state called monoclonal gammopathy of undetermined significance (MGUS). This review focuses on non-IgM MGUS and its progression to MM. Although certain clinical markers of MGUS progression have been identified, it currently is not possible to accurately determine individual risk of progression. This review focuses on the various biologic and molecular markers that could be used to determine the risk of MM progression. A better understanding of the pathogenesis will allow us to define the biological high-risk precursor disease and, ultimately, to develop early intervention strategies designed to delay and prevent full-blown MM.
Topics: Biomarkers, Tumor; Cytogenetic Analysis; Disease Progression; Genomics; Humans; Molecular Diagnostic Techniques; Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Precancerous Conditions; Prognosis
PubMed: 20958231
DOI: 10.3109/10428194.2010.525725 -
Annals of the Academy of Medicine,... Jul 2022Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable...
Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.
Topics: Adenomatous Polyps; Endoscopy; Humans; Precancerous Conditions; Singapore; Stomach Neoplasms
PubMed: 35906941
DOI: 10.47102/annals-acadmedsg.2021433 -
Carcinogenesis Jan 2018Cumulative evidence indicates that a significant proportion of cancer evolution may occur before the development of histological abnormalities. While recent improvements... (Review)
Review
Cumulative evidence indicates that a significant proportion of cancer evolution may occur before the development of histological abnormalities. While recent improvements in DNA sequencing technology have begun to reveal the presence of these early preneoplastic clones, the concept of 'premalignant field' was already introduced by Slaughter more than half a century ago. Also referred to as 'field effect', 'field defect' or 'field cancerization', these terms describe the phenomenon by which molecular alterations develop in normal-appearing tissue and expand to form premalignant patches with the potential to progress to dysplasia and cancer. Field effects have been well-characterized in ulcerative colitis, an inflammatory bowel disease that increases the risk of colorectal cancer. The study of the molecular alterations that define these fields is informative of mechanisms of tumor initiation and progression and has provided potential targets for early cancer detection. Herein, we summarize the current knowledge about the molecular alterations that comprise the field effect in ulcerative colitis and the clinical utility of these fields for cancer screening and prevention.
Topics: Animals; Cell Transformation, Neoplastic; Colitis, Ulcerative; Colorectal Neoplasms; Humans; Precancerous Conditions
PubMed: 29087436
DOI: 10.1093/carcin/bgx117 -
Cancer Biomarkers : Section a of... 2010Barrett's esophagus is a condition in which the stratified squamous epithelium of the distal esophagus is replaced by specialized intestinal metaplasia. Clinical... (Review)
Review
Barrett's esophagus is a condition in which the stratified squamous epithelium of the distal esophagus is replaced by specialized intestinal metaplasia. Clinical management of Barrett's esophagus, like many other "premalignant" conditions, is characterized by overdiagnosis of benign early changes that will not cause death or suffering during the lifetime of an individual and underdiagnosis of life-threatening early disease. Recent studies of a number of different types of cancer have revealed much greater genomic complexity than was previously suspected. This genomic complexity could create challenges for early detection and prevention if it develops in premalignant epithelia prior to cancer. Neoplastic progression unfolds in space and time, and Barrett's esophagus provides one of the best models for rapid advances, including "gold standard" cohort studies, to distinguish individuals who do and do not progress to cancer. Specialized intestinal metaplasia has many properties that appear to be protective adaptations to the abnormal environment of gastroesophageal reflux. A large body of evidence accumulated over several decades implicates chromosome instability in neoplastic progression from Barrett's esophagus to esophageal adenocarcinoma. Small, spatial scale studies have been used to infer the temporal order in which genomic abnormalities develop during neoplastic progression in Barrett's esophagus. These spatial studies have provided the basis for prospective cohort studies of biomarkers, including DNA content abnormalities (tetraploidy, aneuploidy) and a biomarker panel of 9p LOH, 17p LOH and DNA content abnormalities. Recent advances in SNP array technology provide a uniform platform to assess chromosome instability.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Barrett Esophagus; Biomarkers, Tumor; Chromosomal Instability; Disease Progression; Epigenesis, Genetic; Esophageal Neoplasms; Humans; Precancerous Conditions; Risk Assessment
PubMed: 22112482
DOI: 10.3233/CBM-2011-0162 -
Journal of Cellular and Molecular... 2009There is increasing evidence to show that only a subset of cancer cells drives the growth and progression of a tumour. These cells share similar properties with normal... (Review)
Review
There is increasing evidence to show that only a subset of cancer cells drives the growth and progression of a tumour. These cells share similar properties with normal stem cells and are termed 'cancer stem cells'. Cancer stem cells have been identified in acute myeloid leukaemia and in some solid tumours by their distinct expression of cell surface antigens. Their long-term, self-renewing capacity is thought to be a determining factor in the maintenance and regrowth of the tumour. Studies on haematopoietic cancers show that important signalling pathways and genes for normal haematopoiesis, such as Wnt, NF-kappaB, Notch, hedgehog (Hh) and Bmi1, are oncogenic, thereby potentially involved in cancer stem cell regulation. Elimination of cancer stem cells in tumours could result in the degeneration of downstream cells, which makes them potential targets for new cancer therapies.
Topics: Animals; Cell Differentiation; Hematopoiesis; Humans; Models, Biological; Neoplastic Stem Cells; Precancerous Conditions; Stem Cell Niche
PubMed: 19175465
DOI: 10.1111/j.1582-4934.2008.00664.x