Neoplastic Development in Airway Epithelium

Abstract

Bronchogenic carcinoma is the most common fatal neoplastic disease in many parts of the world. The etiology of bronchogenic carcinoma is more firmly established than that of most other cancers. The evidence is overwhelming that most lung cancers are caused by tobacco smoke inhalation, the incidence depending on the duration of exposure and dose rate. Bronchogenic carcinoma is one of the few types of cancers with a well-defined etiology. However, factors, other than carcinogen exposure, which are important determinants of lung cancer induction are not certain. With the recent introduction of in vivo and in vitro approaches for the study of neoplastic development and the advances in culture systems that can be used for investigating the transformation of airway epithelial cells, the cellular analysis of the biologic potential of dysplastic airway lesions and the progression of initiated cells is now feasible. The chapter summarizes and critically analyzes primarily the information relevant to the induction and development of those cells and tissue changes that may progress to invasive cancer. Future investigations will no doubt lead to the discovery of new markers of neoplastic transformation and to a more complete understanding of the multiphasic process of neoplastic development as it occurs in the epithelial lining of the airways.