Detection of Field Cancerization in The Clinically Normal Oral Mucosa of Cannabis and Cigarette Smokers
Keywords:Head and neck cancer, oral cancer, cannabis smoking, cigarette smoking, field cancerization
Background: Head and neck cancer represents one of the most common cancer types. Numerous risk
factors are implicated in the development of HNSCC. In our study we aimed to investigate the changes that
occur 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 cigarette
smokers, cigarette smokers and non-smokers. The biopsies were examined by routine H&E techniques and
immunohistochemical expression of p53.
Conclusion: The present work demonstrated evident dysplastic and pre-dysplastic changes in H&E stained
sections. The changes were detected histologically in both smoker groups. These changes were more
pronounced in cannabis smokers’ group than cigarette smokers’ group. Moreover, p53 immunostaining was
higher for cigarette smokers’ group than cannabis smokers’ group. It is evident that cigarette smoking and
cannabis smoking results in field changes in the oral mucosa which are detectable in tissue sections. These
changes, such as hyperplasia and dysplasia are more detectable in H&E sections of cannabis smokers than
cigarette smokers. However, positive p53 immunoexpression was lower in cannabis smokers than cigarette
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