Preliminary research indicates that several specific genetic alterations are associated with the development of smoking-related head and neck skin cancers, according to a report in this month's issue of the Journal of the American Medical Association.

Dr Charis Eng, of the Genomic Medicine Institute at the Cleveland Clinic Foundation, Cleveland, and colleagues conducted a study to determine the extent of genomic alterations in the stroma (connective tissue) of head and neck squamous cell carcinoma (SCC; a type of cancer similar to the common form of skin cancer). Tumour epithelium (the cancer itself) and surrounding stroma were isolated from 122 patients with oral cavity and oropharyngeal or hypopharyngeal SCC and these tissues were subjected to whole genome analysis.

Tumour-associated stroma of head and neck SCC from smokers were found to have a high degree of genomic alterations. A correlation between tumour aggressiveness could be found for a specific set of 5 loci. Three stroma-specific loci were associated with tumour size and regional nodal (small mass) metastases. Also, two specific genomic alterations (markers termed “hot spots”) were positively correlated with node metastases and clinical stage.

“Stroma-specific genetic alterations are associated with smoking-related head and neck SCC genesis,” the authors write. “We hope that our genomic observations, which point to genomic regions that may harbor many genes, will guide future in-depth functional and mechanistic studies. Nevertheless, our current observations can be used to identify new biomarkers for prediction of clinical outcome and potentially novel compartments for targeted therapy and prevention.”