Squamous Intraepithelial Lesions

Histological changes of the squamous epithelium that occur in the process of oral, oro- and hypopharyngeal and laryngeal carcinogenesis, are cumulatively designated s quamous intraepithelial lesions (SILs). The term SILs has been proposed as an all-embracing ex-

pression of the whole spectrum of epithelial changes ranging from squamous cell hyperplasia to carcinoma in situ.

It has been widely accepted that the transition from normal mucosa to invasive squamous cell carcinoma (SCC) is a comprehensive and multistage process, causally related to a progressive accumulation of genetic changes leading to the selection of a clonal population of transformed epithelial cells [144]. Between six and ten independent genetic events are required for progression to SCC [300]. In their evolution, some cases of SIL are self-limiting and reversible, some persist, and some of them progress to SCC in spite of treatment [78]. Particular interest has been focused on potentially malignant or risky (precancerous) lesions [48, 181, 200, 223]. These lesions have been defined as histomorphological changes of the squamous epithelium from which invasive cancer develops in a higher percentage than from other epithelial lesions [125, 179, 181, 223]. A fundamental enigma of potentially malignant lesions remains when and under what conditions these changes turn to malignant growth [180, 223].

Various aetiological, clinical, histological and molecular genetic aspects are significant for the evaluation, adequate treatment and predictive behaviour of SILs, particularly of potentially malignant lesions.

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