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Premalignant Lesions

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Genomics, Personalized Medicine and Oral Disease

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Abstract

Head and neck squamous cell carcinoma can lead to high morbidity and mortality, and exhibits a significant difference in prognosis based on the clinical stages of diagnosis. Clinically demonstrable premalignant lesions precede most but not all cases of head and neck cancer; some oral premalignant lesions may not present with cytologic alterations. This chapter highlights the importance of recognizing oral premalignant lesions and identifying those with potential for malignant transformation. The concept of “field cancerization” is discussed, as is the emerging role of HPV-associated premalignancy. We also cover the well-recognized pathobiological mechanisms, including chromosomal instability and altered signaling pathways that inactivate tumor suppressor genes and/or activate oncogenes. Finally the role of the tumor microenvironment and the concept of “super competition” in the initiation and progression of oral premalignant lesions are addressed. In conclusion and in an attempt to emphasize the importance of early detection, possible applications of novel technologies such as expression profiling and current detection techniques are discussed.

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Authors and Affiliations

  1. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, 02115, Boston, MA, USA

    Chia-Cheng Li DDS, MS, DMSc, Reshma S Menon BDS & Sook-Bin Woo DMD, MMSc

  2. Division of Genetics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Chia-Cheng Li DDS, MS, DMSc & Zhe Li PhD

  3. Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Boston, MA, USA

    Sook-Bin Woo DMD, MMSc

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  1. Chia-Cheng Li DDS, MS, DMSc
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  2. Zhe Li PhD
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  3. Reshma S Menon BDS
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  4. Sook-Bin Woo DMD, MMSc
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Correspondence to Chia-Cheng Li DDS, MS, DMSc .

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  1. Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Stephen T. Sonis, DMD, DMSc

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Li, CC., Li, Z., Menon, R., Woo, SB. (2015). Premalignant Lesions. In: Sonis, DMD, DMSc, S. (eds) Genomics, Personalized Medicine and Oral Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-17942-1_12

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