Estrogen metabolism as a risk factor for head and neck cancer

OBJECTIVE: Estrogen metabolites have been associated in the pathogenesis of breast and cervical cancer; 16alpha -hydroxyestrone(16alpha-OHE1) demonstr ated proliferative effects whereas 2-hydroxyestrone(2-OHE1) had antiprolife rative 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 16alpha-OHE1 from 50 H&N cancer patients and 50 age- and sex-matched controls were measured usin g enzyme-linked immunosorbent assay (ELISA). Absolute values and 2-/16alpha -OHE1 ratios were calculated. Conditional logistic regression for univariat e and multivariate analysis with odds ratio (OR) and 95% confidence interva l (CI) were used. RESULTS: Thirty percent (15 of 50) from the case group had a low 2-/16alpha -OHE1 ratio compared with only 4% (2 of 50) in the control group (OR = 11.1 ; 1.4-91.5, 95% CI) (P < 0.05). When adjusted for tobacco, OR remained sign ificant at 15.6 (1.1-212.5, 95% CI) (P < 0.05), CONCLUSION: H&N cancer patients are more likely to express abnormal estroge n metabolism than healthy controls; 2-/16 alpha -OHE1 may serve as a potent ial biological marker of individuals at increased risk of H&N cancer.