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Main parameters affecting promotion of laryngeal and oral cavity cancers: A study for the formulation of a pratical risk index

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Menicagli, R., Duca, M. and Arizzi, C.

Introduction and Objectives: A recent study in laringectomizzati patients, showed that other parameters, in addition to smoking and HPV, such as autoimmune diseases, sex, lifestyle, can be considered important risk factors to activate the process of carcinogenesis of the oral cavity and laryngeal .This study assigns each individual risk factor score, and identifies the theoretical threshold, beyond which we must implement a monitoring in detecting and removing those factors and symptoms that indicate a possible irreversible damage to the protective structure made from the salivary mucin the objectives of this study, to prove the validity of this index on a larger sample of laringectomizzati and verify, in a first preliminary experiment if the risk factors of age, sex and smoking, , with the determination of Free Radicals can vary the theoretical score, according to the concentration of malondialdehyde salivary secure indicator of cell damage Materials Study Method: was administered to eighty laryngectomees a questionnaire that asked them what habits, diseases and / or symptoms, considered as a whole "risk factors", nine in total, which were present before he was diagnosed with their cancer the final data were compared statistically by the Fisher Exact Test, with those of a control population. In parallel with the experimental tests have been started to determine the saliva by dip sticks, the concentration of free radicals, which occurs in the presence of three of the major risk factors, taken individually: age, smoking and sex The calculation of the correlation between smoking, age , sex and cigarette consumption was determined by Logistic regression, establishing the cutoff values for the concentration of malondialdehyde Results and Discussion: The result of questionnaire confirmed that age smoking is a significant percentage of patients with laryngeal cancer risk factor that has an autoimmune disease is higher than the figure of the Italian general population (26% vs 1%, p <0.0001, with a test of proportions) the smoke and the presence of an autoimmune disease are not two associated risk factors (p = 0.1211 by Fisher exact test). The results also indicate that the presence of an autoimmune pathology is a significant risk factor for cancers of the larynx (at least in the sample analyzed by us), having a value of 26% in laryngectomees vs 7% in the controls, (p = 0.0123 by Fisher exact test). The data also suggest that there may be individual risk factors also hypogeusia and xerostomia (p = 0.0563 and p = 0.0559, respectively) and that the latter could be a specific risk factor for men (27% in men laringectomees vs 3% of the control men, p = 0.0260 by Fisher exact test).Smoking ≤ 7 cigarettes / day, it does not involve a significant Increase in MDA control, compared with the men's group, while smoking≥ 7 cigarettes / day, implies a Significantly increased at risk Older age ≥45 years, it has a significant effect on Increasing the MDA, both in smokers, and men in the control group The increase in the concentration of salivary MDA value (greater than 3 nM / ml) in the control group women's relative to 21% of the control group for ages above 49 years. These indicate that the age, gender and smoking can substantially be reassessed score for the theoretical effect of the concentrations of salivary MDA found in smokers compared with the two control groups of men and women Conclusions: It can indicate the age factor in man, three values of cut-off, obtained either from the control population; the first regards younger than 40 -44 years with values of less than 3 nM MDA / ml, the second age 44-60 with concentrations of MDA ≥3≤5, and a third of persons who have passed these years For women, you have to change the values 0/1, depending on the major or minor age of sixty years, but you have to take as a reference the average age of onset of menopause FOR As for the other risk factors you will have to determine the salivary MDA for autoimmune diseases and in different life styles, without affecting its overall score assigned to i others risk factors



               Prof. Dr. ISMAIL YILDIRIM