Abstract
It was hypothesised that one may be able to visualise field changes, which are proposed to exist around tumours, as alterations in keratin intermediate filament protein expression. Standard immunohistochemical analysis using a panel of monoclonal anti-keratin antibodies was applied to fresh tissue sections to look for subtle changes in epithelial differentiation not visible in H&E sections. Such changes were observed in clinically normal epithelium from oral cancer patients, involving primarily substantial expression of keratins K8/K7 (using CAM 5.2) in the basal cells of 12 out of 34 biopsies, and also a trend towards a reduction in the complexity of keratin differentiation. Monitoring such changes may prove to be a valuable adjunct to conventional H&E staining if found to have prognostic and diagnostic significance.
Highlights
Slaughter's paper (1953) is frequently quoted to support the concept of field change, little evidence exists to confirm it
We have reported a reduction in cytoplasmic area (CA) for normal buccal mucosa in patients with malignant disease both distant from and within the oral cavity, compared with cancer free patients (Ogden et al, 1990)
In each case the tumour had been confirmed as a squamous cell carcinoma following routine histopathological examination
Summary
The aims of this paper are to examine the evidence of field change in tissue sections of normal oral mucosa from oral cancer patients and compare the findings to cancer free patients using immunohistochemistry to identify changes in cytokeratin expression
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