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p53 Mutations in Nonmelanoma Skin Cancer of the Head and Neck: Molecular Evidence for Field Cancerization¹

Departments of Immunology [S. K., K. K. C., L. A. H., M. L. K., H. N. A.], Epidemiology [S. S. S., M. R. S.], Head and Neck Surgery [G. L. C., R. S. W.], and Pathology [A. K. E-N.], University of Texas M. D. Anderson Cancer Center, and the Department of Pathology, Baylor College of Medicine [V. K.], Houston, Texas 77030

Multiple and distinct p53 mutations were detected by DNA sequence analysis in tumor and adjacent nonmalignant skin samples from eight patients with nonmelanoma skin cancer of the head and neck, providing unambiguous evidence for field cancerization. The mutations consisted of CT transitions at dipyrimidine sequences (30% of all single base substitutions), TC transitions (47%), and GT transversions (12%), suggesting that other carcinogens may act along with UV radiation in the development of nonmelanoma skin cancer. Patient interviews revealed that, in addition to substantial exposure to solar UV radiation, most had a history of smoking and were exposed to carcinogens from industrial or agricultural sources. These data show that extensive molecular epidemiological investigations are necessary to elucidate risk factors associated with the disease in localities where patients often report substantial exposure to environmental carcinogens.

¹ Supported by a Physicians Referral Service grant from The University of Texas M. D. Anderson Cancer Center (H. N. A.).

² Supported in part by a fellowship from the Smith Education Fund and NCI Grant CA67137.

³ To whom requests for reprints should be addressed, at the Department of Immunology, Box 178, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.

Received 2/ 6/95. Accepted 6/14/95.

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