Mutagen sensitivity of patients with cancer at different sites of the head and neck.

In the aetiology of head and neck squamous cell carcinoma (HNSCC), smoking and heavy alcohol consumption are the main environmental risk factors. The bleomycin (BLM) sensitivity assay is believed to measure environment-related cancer risks, mainly of HNSCC. Previously, we have shown that this method is only moderately sensitive to identify individuals at high risk for developing HNSCC, due to broad overlap of BLM-induced chromatid breaks per cell (b/c) between cancer patients and controls, and alcoholics with liver diseases. In the present study, we evaluated whether the differences between patients and controls are more manifested when the risks according to localization of HNSCC are examined. BLM sensitivity in lymphocytes of 278 patients with HNSCC at four different anatomical sites, and that of 356 frequency-matched controls was studied. There was a significant difference in BLM-induced b/c values between patients (1.11 b/c) and controls (0.97 b/c); however, considering all HNSCC cases, only 58.3% of patients and 43.3% of controls were mutagen sensitive. When the patients were distributed according to tumour sites, mutagen sensitivity of those with cancer of oral cavity, oropharynx and hypopharynx was significantly higher than that of the frequency-matched controls (1.12-1.14 b/c versus 1.00 b/c), while laryngeal tumour patients (1.05 b/c) did not differ from controls (1.00 b/c). When the associations between BLM sensitivity and the risk of HNSCC sites were examined, it was expressed mostly in patients with tumours of the oral cavity and oropharynx (OR = 1.97 and OR = 1.90), and not in patients with tumours of the hypopharynx and larynx. Though the mutagen sensitivity decreased from the oral cavity down to the larynx, indicating that the site-specific risks may differ, the BLM assay shows weak and controversial associations between mutagen sensitivity and cancer risk of patients even at specific HNSCC sites.