Document Type : Original Article
Authors
- Zohreh Dalirsani 1
- Zahra Delavarian 1
- Atessa Pakfetrat 1
- Seyed Isaac Hashemy 2
- Leyla Vazifeh Mostaan 3
- Fahimeh Khaghani 4
- Mahboobeh Taherizadeh 5
- Maede Shokri 6
- Hossein Alavi 7
1 Oral and Maxillofacial Medicine, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Dept. of Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Dept. of Otolaryngology, Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Dept. of Periodontics, North Khorasan University of Medical Sciences, Bojnourd, Iran.
5 Master Degree of Mathematical Statistics, Mashhad, Iran.
6 General Dentist, Mashhad, Iran.
7 Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Background: Micronutrients and trace elements have been linked to the development of head and neck squamous cell carcinoma (HNSCC). However, the role of these elements in the etiology of HNSCC remains unclear.
Purpose: This study was conducted to investigate the association between micronutrient and trace element levels and the risk of HNSCC.
Materials and Method: In this case-control study, serum concentrations of iron, selenium, zinc, copper, and calcium were measured in 40 patients with HNSCC and compared to those of 37 healthy subjects. Statistical analysis was conducted using the Mann-Whitney test, Chi-square test, and independent t-test.
Results: The mean ages of the case and control groups were 62.80±13.029 and 57.92± 9.367, respectively, with 45% of HNSCC patients and 59.5% of control subjects being male (p= 0.205). Serum concentrations of calcium and copper were higher, and those of selenium, zinc, and iron lower in the case group than in the control group. Adjusted logistic regression showed only copper, calcium, and iron concentrations to be significantly different between the two groups (p= 0.003, p= 0.018, and p= 0.047, respectively).
Conclusion: The case group had lower levels of iron, zinc, and selenium, and higher levels of calcium and copper than the control group. Evaluating serum concentrations of these trace metals could be useful for further screening of individuals at high risk.
Highlights
Zohreh Dalirsani (Google Scholar)
Atessa Pakfetrat (Google Scholar)
Keywords
- Khanna S. Immunological and biochemical markers in oral carcinogenesis. the public health perspective. Int J Enviro Res Public Health. 2008; 5: 418-422.
- Marocchio LS, Lima J, Sperandio FF, Corrêa L, de*Sousa SO. Oral squamous cell carcinoma: an analysis of 1,564 cases showing advances in early detection. J Oral Sci. 2010; 52: 267-273.
- Taghavi N, Yazdi I. Type of food and risk of oral cancer. Arch Iranian Med. 2007; 10: 227-232.
- Richie JP, Kleinman W, Marina P, Abraham P, Wynder EL, Muscat JE. Blood iron, glutathione, and micronutrient levels and the risk of oral cancer. Nutr Cancer. 2008; 60: 474-482.
- Maserejian NN, Giovannucci E, Rosner B, Joshipura K. Prospective study of vitamins C, E and A and carotenoids and risk of oral premalignant lesions in men. Int J Cancer. 2007; 120: 970-977.
- Bravi F, Bosetti C, Filomeno M, Levi F, Garavello W, Galimberti S, et al. Foods, nutrients and the risk of oral and pharyngeal cancer. British J Cancer. 2013; 109: 2904-2910.
- Akinmoladun V, Owotade F, Olusanya A. Trace metals and total antioxidant potential in head and neck cancer patients. Ann Afr Med. 2013; 12: 131-134.
- Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med. 1998; 18: 673-685.
- Malinowska K, Morawiec-Sztandera A, Majsterek I, Kaczmarczyk D. Effect of copper(II) the activity of glutathione peroxidase in patients with head and neck cancer. Otolaryngol Pol. 2016; 70: 20-25.
- Morisawa A, Okui T, Shimo T, Ibaragi S, Okusha Y, Ono M, et al. Ammonium tetrathiomolybdate enhances the antitumor effects of cetuximab via the suppression of osteoclastogenesis in head and neck squamous carcinoma. Int J Oncology. 2018; 52: 989-999.
- Jamshidi-Naeini Y, Esmaeili S, Akbari ME, Davoodi H. Iron deficiency and overload and its association with cancer risk in humans: a review. Koomesh. 2015;16: 289-300.
- Hu Z, Wang L, Han Y, Li F, Zheng A, Xu Y, et al. Ferritin: A potential serum marker for lymph node metastasis in head and neck squamous cell carcinoma. Oncology Letters. 2019; 17: 314-322.
- Rosol TJ, Capen CC. Mechanisms of cancer-induced hypercalcemia. Lab Invest. 1992; 67: 680-702.
- Khanna SS, Karjodkar FR. Circulating immune complexes and trace elements (Copper, Iron and Selenium) as markers in oral precancer and cancer: a randomised, controlled clinical trial. Head Face Med. 2006; 2: 33.
- Bassey IE, Akpan UO, Elijah OE, Bankong SO. Thyroid function determinants, calcium, phosphate and vitamin D in adult male smokers in Calabar, Nigeria. J Med Allied Sci. 2018; 8: 7-12.
- Khanna S, Udas AC, Kumar GK, Suvarna S, Karjodkar FR. Trace elements (copper, zinc, selenium and molybdenum) as markers in oral sub mucous fibrosis and oral squamous cell carcinoma. J Trace Elem Med Biol. 2013; 27: 307-311.
- Tiwari R, David CM, Mahesh DR, Sambargi U, Rashmi KJ, Benakanal P. Assessment of serum copper, iron and immune complexes in potentially malignant disorders and oral cancer. Brazilian Oral Res. 2016; 30: e101-e109.
- Baharvand M, Manifar S, Akkafan R, Mortazavi H, Sabour S. Serum levels of ferritin, copper, and zinc in patients with oral cancer. Biomed J. 2014; 37: 331-336.
- Li S, Liu Y, Li J, Zhao X, Yu D. Mechanisms of ferroptosis and application to head and neck squamous cell carcinoma treatments. DNA Cell Biol. 2021; 40: 720-732.
- Hosthor SS, Mahesh P, Priya SA, Sharada P, Jyotsna M, Chitra S. Quantitative analysis of serum levels of trace elements in patients with oral submucous fibrosis and oral squamous cell carcinoma: A randomized cross-sectional study. J Oral Maxillofac Patho. 2014; 18: 46-51.
- George T, Honnamurthy JB, Shivashankara AR, Suresh S, Baliga MS. Correlation of Blood and Salivary Levels of Zinc, Iron and Copper in Head and Neck Cancer Patients: An Investigational Study. Avicenna J Med Biochem. 2017; 5: 35-39.
- Chen Q, Lin LS, Chen L, Lin J, Ding Y, Bao XD, et al. Relationship between selenium and the risk for oral cancer: a case-control study. Zhonghua Liu Xing Bing Xue Za Zhi. 2019; 40: 810-814.
- Sonaa*Elango SS, Khashim Z, Subbiah U. Selenium influences trace elements homeostasis, cancer biomarkers in squamous cell carcinoma patients administered with cancerocidal radiotherapy. Asian Pac J Cancer Prev (APJCP). 2018; 19: 1785-1792.
- Shetty SR, Babu S, Kumari S, Shetty P, Hegde S, Karikal A. Status of trace elements in saliva of oral precancer and oral cancer patients. J Cancer Res Ther. 2015; 11: 146-149.
- Kulkarni N, Kalele K, Kulkarni M, Kathariya R. Trace elements in oral health and disease: an updated review. J Dent Res Rev. 2014; 1: 100-104.
- Senevirathna K, Mahakapuge TAN, Ileperuma P, Jayawardana NU, Jayarathne L, Weerasekara R, et al. Correlation between serum heavy metals and the risk of oral squamous cell carcinoma and oral potentially malignant disorders. Scientific Reports. 2024; 14: 19029.
- Sun ZG, Song GM, Zhang M, Wang Z, Ni ZH. Clinical study on magnesium, copper and chrome levels in patients with oesophageal squamous cell carcinoma. Wspólczesna Onkologia. 2011; 15: 257-260.
- Chen F, Wang J, Chen J, Yan L, Hu Z, Wu J, et al. Serum copper and zinc levels and the risk of oral cancer: A new insight based on large‐scale case–control study. Oral Diseases. 2019; 25: 80-86.
- Bibi K, Shah MH. Investigation of imbalances in essential/toxic metal levels in the blood of laryngeal cancer patients in comparison with controls. Biometals. 2023; 36: 111-127.
- Lin TC, Liang KL, Lee LC, Hsu CY, Yen TT. Cancer-related hypercalcemia in oral cancer. Int J Oral Maxillofac Surg. 2018; 47: 685-691.
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