A MODERN VIEW ON THE CONCEPT OF FIELD CANCERIZATION

Abstract

The study aims to analyze modern ideas about the phenomenon of field cancerization, the mechanisms of its pathogenesis and morphogenesis, its importance for the clinical findings, preventive care, early diagnosis, and promising approaches to the treatment of tumors. Material and methods. The literature search is carried out using the following databases: CyberLeninka, PubMed, Nature Pathology, MEDLINE, and PLOS ONE. The search depth does not exceed ten years and is determined by the fundamental nature of the work. The keywords used in the search are tumor field, field cancerization, tumor-stroma interaction. Results. In the works of recent years, the tumor field or the field cancerization is considered to be a tissue with accumulated genetic and epigenetic changes. These changes provide cells with clonal differences and proliferative dominance with a gradual evolution of their phenotype from normal to precancerous (focal hyperplasia, metaplasia and dysplasia, cancer in situ) and tumor, characterized by the appearance of the ability to epithelial-mesenchymal transition, invasion, and metastasis. Among the most important determinants of the formation of the tumor field are aging, the action of chemical and physical mutagens, and chronic inflammation. Whereas among the mechanisms of field formation, DNA methylation and microRNA dysregulation are of great importance. Changes in the stromal compartment of the tissue (extracellular matrix, connective tissue cells) can play a leading role in the initiation of the tumor process, which is determined by the appearance of a special tumor-associated phenotype of fibroblasts and macrophages, as well as changes in the immune status of the tissue. Understanding the concept of the tumor field is of high significance for the early detection of precancerous changes, the prevention of cancer development and its early diagnosis, as well as the development of new tactics of targeted therapy.