Estrogen Metabolism as a Risk Factor for Head and Neck Cancer

Abstract

OBJECTIVE: Estrogen metabolites have been associated in the pathogenesis of breast and cervical cancer; 16α-hydroxyestrone(16α-OHE1) demonstrated proliferative effects whereas 2-hydroxyestrone(2-OHE1) had antiproliferative effects. Our study's objective is to demonstrate that head and neck (H&N) cancer patients metabolize estrogen differently than healthy controls, which may constitute a risk factor for H&N cancer development. STUDY DESIGN: Urinary metabolite levels of 2-OHE1 and 16α-OHE1 from 50 H&N cancer patients and 50 age- and sex-matched controls were measured using enzyme-linked immunosorbent assay (ELISA). Absolute values and 2-/16α-OHE1 ratios were calculated. Conditional logistic regression for univariate and multivariate analysis with odds ratio (OR) and 95% confidence interval (Cl) were used. RESULTS: Thirty percent (15 of 50) from the case group had a low 2-/16α-OHE1 ratio compared with only 4% (2 of 50) in the control group (OR = 11.1; 1.4-91.5, 95% Cl) ( P < 0.05). When adjusted for tobacco, OR remained significant at 15.6 (1.1212.5, 95% Cl) ( P < 0.05). CONCLUSION: H&N cancer patients are more likely to express abnormal estrogen metabolism than healthy controls; 2-/16α-OHE1 may serve as a potential biological marker of individuals at increased risk of H&N cancer.