Estrogen metabolism and laryngeal papillomatosis: A pilot study on dietaryprevention

Evidence exists that estrogen metabolism has a role in the pathogenesis of recurrent respiratory papillomatosis (RRP). This disease has a papillomavir us etiology and is characterized by recurrent benign tumors with a signific ant propensity to become malignant. We have measured the systemic transform ation of estrogen using an enzyme-linked-immunoassay to measure estrogen me tabolites in the urine of patients with RRP and compared these ratios to th e severity of RRP, a measure of the average growth rate of papillomas. Our results show an inverse relationship between the ratio C-2 to C-16 alpha-hy droxylated estrogens and the severity of RRP. In a pilot study, patients co nsumed cruciferous vegetables to induce C-2-hydroxylation. In this group of patients, an increase in the ratio correlated with an improvement in RRP. The ratio did not change in a subset of these patients, and their RRP did n ot improve. Regardless, the ratio correlated with severity of their RRP.