title: Serum levels of folate, homocysteine, and vitamin B12 in head and neck squamous cell carcinoma and in laryngeal leukoplakia.
abstract: BACKGROUND
  The authors evaluated serum levels of folate, homocysteine, and vitamin B(12) 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 B(12) 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 B(12) 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.
authors.affiliation: Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy. almgio@yahoo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Almadori
authors.forename: Francesco
authors.initials: F
authors.lastname: Bussu
authors.forename: Jacopo
authors.initials: J
authors.lastname: Galli
authors.forename: Gabriella
authors.initials: G
authors.lastname: Cadoni
authors.forename: Bruno
authors.initials: B
authors.lastname: Zappacosta
authors.forename: Silvia
authors.initials: S
authors.lastname: Persichilli
authors.forename: Angelo
authors.initials: A
authors.lastname: Minucci
authors.forename: Bruno
authors.initials: B
authors.lastname: Giardina
authors.forename: Maurizio
authors.initials: M
authors.lastname: Maurizi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000097:blood; D006258:Head and Neck Neoplasms / Q000097:blood / Q000473:pathology*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007822:Laryngeal Neoplasms / Q000097:blood / Q000473:pathology*; D007971:Leukoplakia / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12