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Background: The changes in lipid profile have long been associated with cancer because lipids play a key role in maintenance of cell integrity., Aims: The present study evaluated alterations in plasma lipid profile in untreated head and neck cancer patients as well as patients with oral precancerous conditions (OPC) and its association with habit of tobacco consumption., Material and Methods: This hospital-based case control study included 184 head and neck cancer patients, 153 patients with OPC and 52 controls. Plasma lipids including: (i) Total cholesterol, (ii) LDL cholesterol (LDLC), (iii) HDL cholesterol (HDLC) (iv) VLDL cholesterol (VLDLC) and (v) triglycerides were analysed by spectrophotometric kits., Statistical Analysis Used: Student's t-test was performed to compare mean values of the parameters., Results: A significant decrease in plasma total cholesterol and HDLC was observed in cancer patients (P=0.008 and P=0.000 respectively) as well as in patients with OPC (P=0.014 and P=0.000, respectively) as compared to the controls. The plasma VLDL and triglycerides levels were significantly lower in cancer patients as compared to the patients with OPC (P=0.04) and controls (P=0.059). The tobacco habituates showed lower plasma lipid levels than the non-habituates. Our data strengthen the evidence of an inverse relationship between plasma lipid levels and head and neck malignancies as well as OPC., Conclusion: The lower levels of plasma cholesterol and other lipid constituents in patients might be due to their increased utilization by neoplastic cells for new membrane biogenesis. The findings strongly warrant an in-depth study of alterations in plasma lipid profile in head neck cancer patients.

Objective: Altered glycosylation of glycoconjugates is among the important molecular changes that accompany malignant transformation. The aim of our study was to investigate clinical usefulness of circulatory levels of sialic acid, sialoproteins and sialyltransferase for early diagnosis and management of oral cavity cancer (OC) patients., Materials and Methods: Blood samples collected from 210 untreated OC patients, 100 patients with oral precancerous conditions (OPC) and 100 healthy males. OC patients were followed after initiation of anticancer treatment and 394 follow-up samples were also collected. Serum sialic acid levels were measured spectrophotometrically. Sialyltransferase activity was analysed using radioassay. Alpha 2-6 sialoproteins were isolated using lectin affinity chromatography., Results: Serum levels of free, protein bound and total sialic acid as well as their ratio with total proteins were significantly elevated in untreated OC patients compared with healthy individuals, patients with OPC as well as complete responders (CR). Levels of the markers were comparable between untreated OC patients and non-responders. We observed positive correlation between serum levels of the markers and extent of malignant disease. Serum sialyltransferase activity showed significant elevations in OC patients compared with the controls (P<0.001), patients with OPC (P<0.05) and CR (P<0.05). Higher sialic acid levels in OC patients at the time of diagnosis showed poor survival. The changes in serum proteins with terminal alpha 2-6 sialic acid correlated well with the alterations in the levels of sialic acid forms and sialyltransferase activity., Conclusion: Our results confirmed the elevations in sialic acid and sialyltransferase levels in OC patients and suggested potential utility of these parameters in prognostication and treatment monitoring of this neoplasm. The alterations in these parameters in circulation were in accordance with the changes in alpha 2-6 sialylated proteins.

Purpose: To assess the role of biomarker levels in predicting radiotherapy (RT) response in patients with squamous cell carcinoma of buccal mucosa treated with postoperative RT., Materials and Methods: Thirty-one patients with squamous cell carcinoma of buccal mucosa who received postoperative RT were enrolled for the study. Glutathione S-transferase (GST), glutathione reductase (GR), superoxide dismutase (SOD) and catalase activity were analysed from primary tumour and adjacent normal mucosa of the same patients before RT. p53 and p21ras were localized immunohistochemically., Results: Enzyme activation was predicted by comparing the levels of these enzymes in tumour and adjacent normal mucosa. Deactivation of GST, activation of GR, SOD and catalase were associated with poor response to RT. p53 immunoreactivity was associated with failure to respond to RT., Conclusions: These markers may be useful in predicting treatment outcome in patients receiving postoperative RT, although this conclusion requires confirmation in a larger group of patients.

Serum and tumor cytosolic levels of glutathione-S-transferase (GST) and glutathione-reductase (GR) activity were determined spectrophotometrically. The levels were correlated with clinicopathological criteria and a tobacco-associated protein band (T band) found in serum. The results showed significantly decreased mean serum GST levels (p < 0.02) in cancer patients as compared with controls. However, mean serum GR levels were significantly higher in patients than in controls (p < 0.01). T-band-positive patients showed low GST and low GR activity as compared with T-band-negative patients. Tumor cytosolic-enzyme levels of GST and GR activity were significantly higher (p < 0.0003 and p < 0.0001, respectively) than in corresponding adjacent noncancerous mucosa. Tumour cytosolic GST and GR activity showed significant association with clinicopathologic criteria, e.g., stage, histologic grade and nodal involvement. T-band-negative patients showed significantly higher levels of GST (p < 0.0001) than did T-band-positive patients. Low levels of cytosolic GST may be associated with increased susceptibility towards carcinogen-induced damage. The results suggest that the presence of T band in the sera may be associated with a high-risk phenotype due to decreased detoxification ability.

Background: The efficacy of postoperative radiotherapy for squamous cell carcinoma of the buccal mucosa was evaluated., Methods: One hundred seventy-six patients treated between 1989 and 1993 were analyzed. One hundred fifteen patients were treated with surgery alone (Group 1), and 61 patients were treated with a combination of surgery and postoperative radiotherapy (Group 2)., Results: Actuarial 3-year locoregional control in Groups 1 and 2 was 11% and 48% for patients with stage III + IV cancer (P = .001) and 71% and 75% for patients with stage I + II cancer (P = .74), respectively. On multivariate analysis for locoregional failure, surgical margin, bone invasion, high grade, and node involvement were significant factors in Group 1, whereas in Group 2 only tumor thickness was a significant factor. For local failure, margin, bone invasion, and stage in Group 1 and tumor thickness in Group 2 appeared as significant factors. For nodal failure, clinical nodal (cl N0 vs. N+) stage and grade in Group 1 and pathologic nodal stage (pN0 + 1 vs. pN2) in Group 2 were observed as significant factors. On subset analysis, postoperative radiotherapy was observed to have a significant advantage for surgical margins of 2 mm or less in both early pT (T1 + T2) (P = .019) and late pT (T3 + T4) (P = .016) stages. The local failure rate was higher if the time between surgery and radiotherapy was greater than 30 days., Conclusions: Postoperative radiotherapy was effective in decreasing locoregional failure in patients with close surgical margins, tumor thicker than 10 mm, high-grade tumors, positive node, and bone invasion. The effect of interval between surgery and postoperative radiotherapy on local failure was margin-dependent.

Cancer of the upper aerodigestive tract is one of the leading sites of human malignancies in India. Various glycoproteins have been claimed to be specifically associated with cancer. Serum glycoprotein electrophoresis was carried out in sera obtained from 23 healthy individuals [10 without habit of tobacco consumption (NHT) 13 with habit of tobacco consumption (WHT)], 46 patients with oral precancerous conditions (OPC) and 110 untreated patients with upper aerodigestive tract cancer. Eighty-six samples from the cancer patients were also collected after initiation of anticancer therapy. The albumin, alpha, beta and gamma region glycoproteins were quantitated by densitometric scanning after separation by polyacrylamide disc gel (PADG) electrophoresis. Mean values of albumin and alpha region glycoproteins were significantly lower in WHT and patients with OPC as compared to NHT. The gamma region glycoproteins were significantly elevated in WHT, patients with OPC and untreated cancer patients as compared to the NHT. The albumin region glycoproteins were significantly low, whereas, gamma region glycoproteins were significantly elevated in nonresponders as compared to their pretreatment levels. The glycoprotein values in complete responders were comparable with NHT. An extra glycoprotein band was found in the post beta region, in most of the individuals (>50%) with habit of tobacco consumption in all the groups. There was a decrease in the albumin/gamma, alpha/gamma and beta/gamma values in patients with OPC as well as untreated cancer patients as compared to NHT. Albumin/gamma, alpha/gamma and beta/gamma values were lower in nonresponders as compared to their pretreatment value. The results indicate that the alterations in glycoprotein electrophoresis pattern may be useful for early detection of cancer of the upper aerodigestive tract. It may also be helpful in treatment monitoring of cancer patients.

Mitomycin C (MMC)-induced lymphocytic sister chromatid exchange (SCE) frequency was studied in 40 oral cancer (OC) patients, 40 normal tobacco chewers (NC) and in 40 normal healthy individuals not consuming tobacco/areca nut in any form. Significantly higher MMC-induced SCE/cell values were observed among OC patients as compared to healthy non-chewer controls as well as NC. Although the mean SCE frequency for NC was comparable to that of healthy controls, three individuals showed an SCE rate higher than the highest observed among controls. The comparable frequency of the tobacco habit in these three individuals with that of the rest of the thirty-seven individuals indicated the possible involvement of factors other than tobacco consumption for the higher susceptibility to mutagens.