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JNCI Monographs 2001 2001(29):7-15;
© 2001 by Oxford University Press
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Journal of the National Cancer Institute Monographs, No. 29, 7-15, 2001
© 2001 Oxford University Press

Biology of Oral Mucosa and Esophagus

Christopher A. Squier, Mary J. Kremer

Affiliations of authors:Dows Institute for Dental Research, College of Dentistry, University of Iowa, Iowa City.

Correspondence to:Christopher A. Squier, Ph.D., D.Sc., F.R.C.Path, N419 DSB, College of Dentistry, University of Iowa, Iowa City, IA 52242 (e-mail: christopher-squier{at}uiowa.edu).

The mucosal lining of the oral cavity and esophagus functions to protect the underlying tissue from mechanical damage and from the entry of microorganisms and toxic materials that may be present in the oropharynx. In different regions, the mucosa shows adaptation to differing mechanical demands: Masticatory mucosa consists of a stratified squamous keratinized epithelium tightly attached to the underlying tissues by a collagenous connective tissue, whereas lining mucosa comprises a nonkeratinized epithelium supported by a more elastic and flexible connective tissue. The epithelium is constantly replaced by cell division in the deeper layers, and turnover is faster in the lining than in the masticatory regions. Chemotherapeutic agents and radiation limit proliferation of the epithelium so that it becomes thin or ulcerated; this will first occur in the lining regions. The principal patterns of epithelial differentiation are represented by keratinization and nonkeratinization. As keratinocytes enter into differentiation, they become larger and begin to flatten and to accumulate cytokeratin filaments. In addition to the keratins, the differentiating keratinocytes synthesize and retain a number of specific proteins, including profilaggrin, involucrin, and other precursors of the thickening of the cell envelope in the most superficial layers. The concept of epithelial homeostasis implies that cell production in the deeper layers will be balanced by loss of cells from the surface. There is a rapid clearance of surface cells, which acts as a protective mechanism by limiting colonization and invasion of microorganisms adherent to the mucosal surface. [J Natl Cancer Inst Monogr 2001;29:7–15]


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