Detection of Field Cancerization in The Clinically Normal Oral Mucosa of Cannabis and Cigarette Smokers

Abstract

Background: Head and neck cancer represents one of the most common cancer types. Numerous riskfactors are implicated in the development of HNSCC. In our study we aimed to investigate the changes thatoccur in the oral mucosa of cannabis smokers and compare them to cigarette smokers and non-smokers.Methods: Three groups of subjects were included in our study (33 in each group); cannabis and cigarettesmokers, cigarette smokers and non-smokers. The biopsies were examined by routine H&E techniques andimmunohistochemical expression of p53.Conclusion: The present work demonstrated evident dysplastic and pre-dysplastic changes in H&E stainedsections. The changes were detected histologically in both smoker groups. These changes were morepronounced in cannabis smokers’ group than cigarette smokers’ group. Moreover, p53 immunostaining washigher for cigarette smokers’ group than cannabis smokers’ group. It is evident that cigarette smoking andcannabis smoking results in field changes in the oral mucosa which are detectable in tissue sections. Thesechanges, such as hyperplasia and dysplasia are more detectable in H&E sections of cannabis smokers thancigarette smokers. However, positive p53 immunoexpression was lower in cannabis smokers than cigarettesmokers.