Squamous cell carcinoma is a malignant tumor derived from squamous epithelial cells that tend to infiltrate the surrounding tissues and give rise to metastases usually.
Etiology and Predisposing Factors
The cause of squamous cell carcinoma is not known. The cause is thought to relate to the material carcinogens and predisposing factors. The incidence of oral cancer associated with age may reflect a buildup time, genetic changes and the length of exposure to initiators and promoters (such as: chemical, physical irritants, viral, and hormonal influences), and decreased immunologic cellular aging due to aging. Predisposing factors that can lead to the development of oral cancer include tobacco, chewing, alcohol, and other supporting factors such as chronic disease, oral factors, nutritional deficiencies, fungal, viral, and environmental factors.
- Tobacco
Tobacco contains carcinogenic materials such as nitrosamines, polycyclic aromatic, hydrocarbons, nitrosodicthanolamine, nitrosoproline, and polonium.6, 11,13,14 Tobacco is the single etiologic factor is most important. Tobacco can be chewed, or placed in the mouth to suck, in all the circumstances to have carcinogenic effects of tobacco on the oral mucosa.
The effects of tobacco use that is not burned is closely related to the emergence of "oral leukoplakia" and other oral lesions on the cheeks, lower jaw gingiva, alveolar mucosa, floor of the mouth and tongue.
The habit of chewing tobacco in the Asian community with a mixture of betel and areca are frequently and for long periods of time can lead to squamous cell carcinoma corresponds to the mixture of tobacco that is placed in the cavity mulut.13 Chewing tobacco with chewing tobacco can increase the exposure of carcinogen-specific nitrosamines (TSNA ) and nitrosamines derived from areca alkaloids.
- Chewing
Chewing habits is one of the ancient customs that started centuries years ago. Started chewing done by the people in China, Indonesia and India and then spread to the Asian continent. The main composition of chewing betel leaves (Piper betel leaves), betel nut (nut Areaca), whiting (Antacids), and gambier (Uncaria Gambier Roxb) .25 According to the study, chewing activity can cause negative effects on mucosal tissues in the oral cavity associated with oral cancer and squamous cell carcinoma formation of malignant nature due to the composition of chewing, chewing frequency, duration of chewing, and use all night.
- Alcohol
Several studies have shown a link between alcohol consumption increased incidence of squamous cell carcinoma. Alcoholic beverages contain carcinogenic materials such as ethanol, nitrosamines, urethane contaminant. Alcohol can work as a solvent and cause the penetration of carcinogens into the epithelial tissue. Acelylaldehyd an alcohol metabolite that has been identified as a tumor promoter. Alcohol is one of the factors that facilitate the occurrence of leukoplakia, because alcohol consumption can cause irritation of the mucosa.The combination of smoking and alcohol drinking habits lead to a synergistic effect so as to have a greater risk for oral cancer. Cigarette smoke contains carcinogenic ingredients and alcohol cause dehydration and burning sensation that affects the mucous membranes of the mouth. Increased mucosal permeability will lead to chronic stimulation which arises damage and tissue recovery process repeated so upsets the balance of the cell and undergo cell dysplasia.
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