Oral and Oropharyngeal Cancer, Aryl Hydrocarbon Hydroxylase Inducibility and Smoking

Abstract

In a series of 50 consecutive cases with oral or oropharyngeal malignancies, aryl hydrocarbon hydroxylase (AHH) inducibility and smoking habits were studied. 82% of the patients were smokers. The AHH levels were divided into high, intermediate and low groups and were correlated to a healthy control material also divided into the groups mentioned. A significant overrepresentation of patients with a high AHH level (p < 0.0005) as well as an underrepresentation of low AHH levels (p < 0.01) was found. Smokers with a high AHH level run a sixfold risk of developing cancer in this area and develop it earlier in life than people with low or intermediate AHH levels. Recurrences or secondary malignancies in the upper digestive tract or airways were substantially higher in the high AHH level group as compared to the other. A high AHH inducibility level thus is of both pathogenetic as well as prognostic importance in oral and/or oropharyngeal cancer.

Laryngeal Cancer, Aryl Hydrocarbon Hydroxylase Inducibility and Smoking

“…One may speculate if most of the patients who died early had high AHH in duction levels. This would be in consistence with our previous findings in the oral/oropharyngeal study [7], This could also explain the relative over representation of small T, tumours in pa tients with high AHH induction levels and also the small number of advanced tumours in this group, as high AHH levels probably increase the risk of early death. Correspond ingly, a low AHH induction level seems to reduce the risk for early death in cancer: in our study there were 6/17 patients with ad vanced tumours (T3) in this group as com pared to 2/21 in the high induction group.…”

“…We have previously reported on the re sults of a follow-up study of oral and oropha ryngeal cancer, AHH inducibility and smok ing [7], Our Findings support that both smok ing and the levels of the inducible intracellu lar enzyme system, AHH, are of pathoge netic as well as of prognostic significance in oral and oropharyngeal cancer. Thus, of 50 consecutive patients with these varieties of cancer 82% were smokers, and 52% be longed to the group of high AHH induction levels as compared to 8.6% in a normal pop ulation.…”

“…This might depend on the fact that the actual study is partly retro spective. In our earlier prospective study on oral cancer and AHH [7] we found that 12/15 (80%) who died during the observa tion periods (mean 3.5 years) showed high induction levels while the corresponding fig ure in the present study is 9/23 (23%). All 18 patients who died before any AHH test could be performed were autopsied.…”

“…We have previously reported follow-up results on oropharyngeal cancer, smoking and AHH inducibility [7], It should be of special interest, therefore, that similar pat terns seem to exist in laryngeal carcinoma. More than 10 years ago, we described our preliminary results in a smaller, cross-sec tional clinical sample [12], These initial data have recently been compared with observa tions in laryngeal pre-cancerous conditions [13], but the present report concerns a con siderably expanded, total follow-up material of larynx cancer, which both corroborates the original findings and allows some conclu sions on pathogenetic and prognostic fac tors.…”

“…Recurrences or new tumours were also overrepresented in the patient groups with high AHH inducibility who did not quit smoking after the first diagnosis [7],…”