Oral cancer

etiology and pathogenesis

 Squamous cell carcinoma
Introduction to oral cancer
Etiology
Pathogenesis

Reference: Oral pathology clinical pathological

correlations: regezi, sciuba 5th edition
Chapter 2 page 48-52
 Introduction to oral cancer

30,000 new cases in US

3% of all cancer in men 2% in women
in US
In some Asian countries 50% of all
cancer cases
(This may be due to use of smokeless
tobacco use)
 Etiology

Tobacco: considered as the most

important cause
More dangerous types are cigar,
pipe smoking, reverse smoking.
Importance of time-dose relation
ship
smoke less tobacco risk is
comparatively low
 Alcohol :not a carcinogen it self but
add to the risk of oral cancer
development.
Its effect may be due to irritation to
the mucosa and its ability to act as a
solvent for carcinogen especially
those in tobacco.
Alcohol metabolite acetaldehyde
 Micro organisms
Candida albicans - producing
carcinogen called N-
nitrosobenzylmethylamine.
EBV,HPV-?????
 Nutrition : Plummer-vinson syndrome
UV-Light
Immunodeficiency

Modifier rather than initiater of oral cancer

Chronic irritation
Poor oral hygiene
 Pathogenesis

Arising from accumulation of a

number of discrete genetic defects

Oral cancer progress through two

ways 2) increased tumor cell
motility
1) loss of cell cycle control
by
lead to
increased decreased
Proleferation apoptosis
Invasion & metastasis
 Stages of Cancer progression is result of

Up regulation of Down regulation of

oncogene (proto tumor suppressor gene
oncogene) (anti oncogene)

Over expression of Mutation of the gene

oncoprotein give rise release the break of cell
to a clone of cells with cycle
a growth/motility
advantage
Mutation of tumor suppressor
gene is more important than
oncogenes in cancer
progression.
 Alteration of genes that control the
cell cycle have critical importance
Over expression (cyclin D1) of
oncogenic protein or under
expression of antioncogenic protein
(example: Mutation of P53 ) can tip
the balance Tipping of balance
Role of Cyclins, cyclin- dependent
kinase, and cyclin- dependent kinase
inhibitor.
 Alteration in proteins for Apoptosis
(programmed cell death),signal transport,
cell movements (changes in cell adhesion
molecule), extracellular matrix
degeneration
Over expression of angiogenic protein
Changes in Telomere maintaining the
telomere length by the activity telomerase
enzyme give the cell an extended life.

Thank you