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Multiple head and neck tumors: evidence for a common clonal origin
G C Bedi1, W H Westra, E Gabrielson
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21205-2195, USA.
Cancer Research
|June 1, 1996
Summary
Second primary head and neck cancers often arise from a single clone, not independent events. Genetic analysis of X-chromosome inactivation and microsatellites supports this clonal origin theory in some patients.
Area of Science:
- Oncology
- Genetics
- Cancer Research
Background:
- Head and neck cancers frequently develop second primary lesions, either synchronously or metachronously.
- The origin of these secondary tumors is debated, with theories including field carcinogenesis and clonal spread.
Purpose of the Study:
- To investigate the clonal relationship between multiple primary head and neck tumors in female patients.
- To differentiate between independent transformation (field carcinogenesis) and clonal expansion.
Main Methods:
- Analysis of X-chromosome inactivation patterns in multiple tumors from eight patients.
- Microsatellite analysis to assess loss of heterozygosity on chromosomes 9p and 3p.
Main Results:
- Four of four informative cases showed identical X-chromosome inactivation patterns, suggesting a common origin.
- Loss of heterozygosity patterns on chromosomes 9p and 3p provided further evidence of clonal origin in some patients.
- One patient exhibited identical microsatellite alterations at a 3p locus, confirming a single clonal source.
Conclusions:
- Multiple primary head and neck tumors can originate from a single transformed clone in a subset of patients.
- Findings challenge the exclusive "field carcinogenesis" model and support clonal expansion as a mechanism for secondary tumor development.