| Abstract: |
Head and neck cancer is occurring in younger patients in certain areas of the world. The factors that contribute to this process remain poorly defined, emphasizing the need for continued investigations into head and neck carcinogenesis. One potential determinant of disease development may relate to the significance of the host's intrinsic capacity to detoxify carcinogens, ie, through the phase II enzyme family, glutathione-S-transferases. Those patients with deficient GST activity may be at greatest risk. Additionally, genetic studies have suggested that certain chromosomes may be more susceptible to tobacco-induced damage. Chromosome 3p has now been identified as frequently altered both within head and neck cancers as well as within tobacco-induced malignancies. Over the past year numerous reports have addressed potential biologic determinants of not only cancer development, but also its continued progression. These factors may include altered growth factors and their receptors, changes in cellular intermediate filaments such as increased cytokeratin 19, and the production of matrix metalloproteinases. Finally, investigations continue to provide new insight into mechanisms by which abnormal gene expression may govern response to therapy. Our growing understanding of the complexity of head and neck cancer biology reinforces the need for preventive strategies, including the role of both nutritional and behavioral interventions. |
