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Serum levels of folate, homocysteine, and vitamin B12 in head and neck squamous cell carcinoma and in laryngeal leukoplakia

  1. Giovanni Almadori M.D.1,†,*,
  2. Francesco Bussu M.D.1,
  3. Jacopo Galli M.D.1,
  4. Gabriella Cadoni M.D.1,
  5. Bruno Zappacosta M.D.2,
  6. Silvia Persichilli Ph.D.2,
  7. Angelo Minucci Ph.D.2,
  8. Bruno Giardina Ph.D.2,
  9. Maurizio Maurizi M.D.1

Article first published online: 8 DEC 2004

DOI: 10.1002/cncr.20772

Issue

Cancer

Cancer

Volume 103, Issue 2, pages 284–292, 15 January 2005

Additional Information

How to Cite

Almadori, G., Bussu, F., Galli, J., Cadoni, G., Zappacosta, B., Persichilli, S., Minucci, A., Giardina, B. and Maurizi, M. (2005), Serum levels of folate, homocysteine, and vitamin B12 in head and neck squamous cell carcinoma and in laryngeal leukoplakia. Cancer, 103: 284–292. doi: 10.1002/cncr.20772

Author Information

  1. 1

    Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy

  2. 2

    Institute of Clinical Chemistry, Giardina, Universiàà Cattolica del Sacro Cuore, Rome, Italy

  1. †

    Fax: (011) 39 63051194

*Institute of Otorhinolaryngology, Universitá Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy

Publication History

  1. Issue published online: 5 JAN 2005
  2. Article first published online: 8 DEC 2004
  3. Manuscript Revised: 28 SEP 2004
  4. Manuscript Accepted: 28 SEP 2004
  5. Manuscript Received: 5 JAN 2004

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Keywords:

  • head and neck carcinogenesis;
  • folate;
  • homocysteine;
  • vitamin B12;
  • chemoprevention

Serum folate and homocysteine status is impaired significantly in patients with head and neck squamous cell carcinoma. The data from this report suggest a role for hypofolatemia as a risk factor for head and neck carcinoma, opening intriguing perspectives for chemoprevention.

Abstract

BACKGROUND

The authors evaluated serum levels of folate, homocysteine, and vitamin B12 in patients with head and neck squamous cell carcinoma (HNSCC) and in patients with laryngeal leukoplakia, a well known preneoplastic lesion.

METHODS

One hundred forty-four consecutive, untreated patients with HNSCC and 40 consecutive, untreated patients with laryngeal leukoplakia were enrolled in the Department of Otolaryngology at the authors' institution. Data from those patients were compared with data from one control group, which included 90 smokers, and from another control group, which included 120 nonsmokers. Serum levels of homocysteine, folate, and vitamin B12 were measured by an automated immunoassay method based on fluorescence polarization immunoassay technology.

RESULTS

Comparing groups by Student–Newman–Keuls test, serum folate levels were significantly lower in patients with HNSCC and in patients with laryngeal leukoplakia compared with serum folate levels in both the smoker control group and the nonsmoker control group. Serum homocysteine levels in patients with HNSCC were significantly higher compared with homocysteine levels both in the smoker and nonsmoker control groups and in patients with laryngeal leukoplakia. There were no statistically significant differences between groups in serum vitamin B12 levels.

CONCLUSIONS

A role for folate deficiency as a risk factor in head and neck carcinogenesis is plausible. A chemoprevention protocol with folate is both feasible and ethically correct and is in progress at the authors' institution. Homocysteine levels in patients with HNSCC probably are affected largely by the HNSCC phenotype. An accumulation of homocysteine may reveal a genetic defect, which, theoretically, may be a target for pharmacologic therapy, for example, with antifolic drugs. Cancer 2005. © 2004 American Cancer Society.

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