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June 1, 1994

Otolaryngology—Head and Neck Surgery

Author Affiliations

The Johns Hopkins University School of Medicine, Baltimore, Md; Duke University Medical Center, Durham, NC

JAMA. 1994;271(21):1698-1700. doi:10.1001/jama.1994.03510450070039

Our understanding of the biology and genetics of oncogenesis of the upper aerodigestive tract continues to advance steadily with approaches similar to those described in carcinoma of the colon and breast.

Boyle et al1 have noted that the incidence of p53 mutations increases from noninvasive to invasive neoplasms of the mucosa of the head and neck. The findings suggest that p53 mutations are early events in the development of squamous cell carcinoma (SCC) of the head and neck. However, the peak incidence of p53 mutations occurs after tumor initiation, which renders their detection less useful as a screening strategy than it might be for other malignancies such as bladder or colon cancer. The authors also analyzed the anatomic locations of the p53 mutations and found them to be similar to those found in other tobacco-induced cancers such as carcinoma of the lung. Metachronous tumors in the same anatomic region

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