Commentary - Journal of Molecular Pathophysiology (2023)
Angiogenesis and Invasion in Squamous Cell Carcinoma: Mechanisms and Implications
Glen Tellez*Glen Tellez, Department of Dermatology, Marquette University, Wisconsin, USA, Email: Telliez1989@gmail.com
Received: 13-Nov-2023, Manuscript No. JMOLPAT-23-123020; Editor assigned: 16-Nov-2023, Pre QC No. JMOLPAT-23-123020 (PQ); Reviewed: 01-Dec-2023, QC No. JMOLPAT-23-123020; Revised: 08-Dec-2023, Manuscript No. JMOLPAT-23-123020 (R); Published: 15-Dec-2023
About the Study
Squamous Cell Carcinoma (SCC) is a type of cancer that arises from squamous epithelial cells. Epithelial cells form the surface layer of the skin and line various organs and cavities within the body. Squamous cell carcinoma can develop in various tissues, including the skin, lungs, esophagus, mouth, throat, and other mucous membranes. Squamous cells are flat, scale-like epithelial cells that constitute the outer layer of the skin (epidermis) and line the respiratory, digestive, and urogenital tracts. Squamous cell carcinoma arises when these cells undergo malignant transformation, losing their normal regulatory mechanisms.
The pathogenesis of squamous cell carcinoma often involves the accumulation of genetic mutations. These mutations may be triggered by exposure to carcinogens, such as Ultraviolet (UV) radiation in the case of skin SCC, tobacco smoke for lung SCC, or Human Papillomavirus (HPV) for oral and genital SCC. The mutational events disrupt cellular homeostasis, leading to uncontrolled cell proliferation and evasion of normal cell death processes [1,2]. Dysregulation of signaling pathways plays a pivotal role in squamous cell carcinoma development. The Epidermal Growth Factor Receptor (EGFR) pathway is frequently implicated. Aberrant activation of EGFR can lead to increased cell division, inhibition of apoptosis, and enhanced angiogenesis, promoting tumor growth. As squamous cell carcinoma progresses, it often induces the formation of new blood vessels (angiogenesis) to supply the growing tumor with nutrients and oxygen. Additionally, cancer cells may acquire the ability to invade surrounding tissues and metastasize to distant organs through lymphatic and blood vessels [3].
Exposure to ultraviolet radiation from sunlight is a major risk factor for the development of cutaneous squamous cell carcinoma. Chronic sun exposure over the years can lead to the accumulation of DNA damage in skin cells. Smoking and heavy alcohol consumption is significant risk factors, particularly for squamous cell carcinoma of the lungs, esophagus, and oral cavity. The carcinogens in tobacco smoke and alcohol can directly damage the epithelial cells lining these organs [4]. Human Papillomavirus (HPV) infection is strongly associated with squamous cell carcinoma of the cervix, anus, and oropharynx. HPV can disrupt normal cellular function and contribute to the transformation of squamous cells into cancerous cells.
Individuals with weakened immune systems, such as organ transplant recipients or those with HIV/AIDS, are at an increased risk of developing squamous cell carcinoma. A compromised immune system is less effective in recognizing and eliminating cancer cells. In cutaneous Squamous Cell Carcinoma, patients may notice the development of a firm, red nodule or a flat sore with a scaly surface. These lesions often arise in sun-exposed areas and may bleed or become ulcerated [5]. Early detection is crucial for successful treatment. Symptoms of Lung Squamous Cell Carcinoma may include persistent cough, chest pain, wheezing, and coughing up blood. As the tumor grows, it can obstruct the airways, leading to respiratory symptoms. Oral Squamous Cell Carcinoma can manifest as white or red patches in the mouth, persistent ulcers, or lumps on the lips or tongue. Difficulty swallowing and changes in voice quality may also be indicative of advanced disease. HPV-associated squamous cell carcinoma in the genital region may present as genital warts, abnormal vaginal bleeding, or lesions on the penis or vulva. Routine screenings and vaccination against high-risk HPV strains are essential preventive measures [6].
A definitive diagnosis of squamous cell carcinoma is established through biopsy, where a sample of the suspicious tissue is examined under a microscope. Histological analysis helps determine the degree of differentiation, providing valuable information for prognosis and treatment planning. Radiological imaging, such as CT scans, MRIs, or PET scans, is employed to assess the extent of tumor involvement, identify metastases, and guide surgical planning [7]. Molecular testing may be conducted to identify specific genetic mutations or alterations that can inform targeted therapy options. Testing for HPV in relevant cases is also crucial for determining appropriate treatment strategies. Surgical excision is a common treatment for localized squamous cell carcinoma. This may involve removing the tumor and surrounding tissues, with the goal of achieving negative margins to reduce the risk of recurrence [8,9].
Cancer cells are targeted and destroyed by radiation therapy. It is often used as a primary treatment or in combination with surgery to enhance local control. Systemic chemotherapy may be recommended for advanced or metastatic squamous cell carcinoma [10]. Immunotherapy has become an effective treatment option for squamous cell carcinoma. Drugs such as immune checkpoint inhibitors can enhance the body's immune response against cancer cells. The prognosis for squamous cell carcinoma varies depending on factors such as the location of the tumor, its size, degree of differentiation, and the presence of metastases. Results are much improved by early identification and intervention. Strategies for preventing squamous cell carcinoma include sun protection to reduce UV exposure, smoking cessation, moderation of alcohol consumption, vaccination against high-risk HPV strains, and regular screenings for early detection.
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