The role of etiological factors in carcinogenesis in young head and neck cancer patients
Révész Mónika
Pathological and Oncological Divison
Dr. Matolcsy András
Országos Onkológiai Intézet
2025-06-27 13:00:00
Clinical Oncology and Radiation Therapy
Dr. Polgár Csaba
Dr. Takácsi-Nagy Zoltán
Dr. Bellyei Szabolcs
Dr. Bogdán Sándor
Dr. Patócs Attila
Dr. Kiss Orsolya
Dr. Dános Kornél
Head and neck squamous cell carcinoma (HNSCC) was estimated to be the sixth most common cancer with approximately 800,000 new cases annually worldwide. Although HNSCC usually occurs in patients over 60 years, in the past half century the incidence also increased in young adults. Our aim was to characterize the clinical features, the age distribution and the prevalence of classical risk factors in the young patient group in comparison with a non- preselected institutional general HNSCC population.
The study design consisted of two sequential parts. In both studies we involved patients who were diagnosed with primary head and neck squamous cell carcinoma which originated from lip, oral cavity, meso- hypopharynx and larynx localizations.
In the first part of the study we analyzed the data of 85 young patients in comparison with 140 institutional general HNSCC patients. The age distribution (two third of the young patients were 35-39 years old) and the high prevalence of traditional risk factors among the young patients as well as the predominance of the oral cavity tumor localization suggest that young HNSCC patients might have an exceeded vulnerability to various carcinogens, however, a more aggressive tumor phenotype could not be exluded solely on an epidemiological basis. To investigate the latter possibility, in the second part of the study, we chose the enhancer of zeste homolog 2 (EZH2) in combination with the tumor supressor protein P53 to characterize the HNSCC tumor cells of young patients. EZH2 is a marker of tumor cell viability, and aggressivity, which has a well-defined oncogenic role also in tumor progression, metastasis, drug resistance, and in the modulation of anti-tumor immunity in various cancers. We determined the expression of EZH2 and P53 in the HNSCCs of 68 young patients in comparison with 58 gender and localization matched general HNSCC patients. Lower EZH2 and similar P53 expressions were found to characterize tumors of all localizations in young HNSCC patients.
The lower EZH2 expression of young HNSCC patients’ tumors discourages speculations toward a more malignant phenotype of early onset tumors and suggests the dominant role of host factors (including cell cycle control and tumor immunity). Furthermore our results might also raise the possibility of an altered efficacy of the novel anti-EZH2 therapies in this patient subgroup.
