Serum Levels of Single-Carbon Metabolism Vitamins and Homocysteine in Head-and-Neck Squamous Cell Carcinoma: Preliminary Report

BACKGROUND: Head-and-neck carcinomas are a heterogeneous group of malignancies arising from the upper aerodigestive tract. Tobacco and alcohol are the leading etiological factors; however, bioactive food components, including those that modulate DNA methylation, are being linked to susceptibility. This work assesses the distribution of head-and-neck cancers presenting at a tertiary health institution and determined the serum level of the vitamins and an amino acid involved in the methionine cycle, in view of increasing acceptance of the significant role of DNA methylation in the pathogenesis of cancers. PATIENTS AND METHODS: This study involved 30 newly diagnosed cases of head-and-neck squamous cell carcinoma. Thirty apparently healthy volunteers served as controls. The test cases were made up of 19 males and 11 females while controls were made up of 14 males and 16 females. The median ages of the test cases and controls were 59 and 63 years, respectively. Sera obtained from participants' blood were analyzed by high-performance liquid chromatography technique. The study protocol was approved by the joint University of Ibadan/University College Hospital Institution Review Board. RESULTS: There is a male dominance in the number of cases at male-to-female ratio of 1.7: 1. The oral cavity was the most-affected site. Serum levels of Vitamin B(2), B(6), B(12), and homocysteine were lower in cases compared with controls but not significantly so. However, serum Vitamin A and folic acid levels were significantly lower among the cases ([0.62 vs. 0.71, z = −2.50, P = 0.02], [26.05 vs. 30.82, z = 0.20, P = 0.00]) compared with controls. Only tobacco and alcohol use showed a significant association with head-and-neck cancer, but not family history of cancer or alcohol use alone (P = 0.00). CONCLUSION: Significantly low serum Vitamin A and hypofolataemia are associated with head-and-neck squamous cell carcinoma. This is suggestive of a role for these vitamins in the etiopathogenesis of the disease.