Analysis of the role and impact of sex hormones in diagnostics and assessment of clinical progress of laryngeal cancer.

Abstract

Background. A significant portion in the structure of head and neck cancer epidemiology is represented by laryngeal cancer, death rate of which among the European countries ranges from 13.1 per 100,000 people in Hungary to 0.9 per 100,000 people in Sweden. Due to the data of previous epidemiologic studies, it is obvious that unequal gender distribution of the laryngeal cancer prevalence associated with features of the different sexes, a significant role in the formation of which provided by hormonal factors. Objective. The purpose of this study was to analyze the role and influence of sex hormones in the diagnostics and clinical progress assessment of laryngeal cancer for further argumentation of its greater prevalence among the male population; and systematization of relevant published data examining the related hormonal changes during tumorogenesis of specific neoplasmatic larynx’s lesion, published from 2000. Methods. Patients sample consisted of 48 people, who were male patients of Transcarpathian Regional Hospital and Uzhgorod Cancer Center with diagnosed laryngeal cancer established by the results of clinical examination and biopsy analysis. The monitoring group was selected in a similar number of participants consisted of healthy individuals. Nature, localization, prevalence and other morphological features of laryngeal pathological processes were determined by histological method. During laboratory diagnostics was conducted evaluation of testosterone, estradiol and prolactin levels in the blood of patients from the study group and the control group, with further evaluation of 17-ketosteroids, testosterone and the female sex hormones in the urine material. Analysis of the numerical data was performed using application software Microsoft Excel 2016 (Microsoft Office 2016). Results. Most of the patients with laryngeal cancer had increased concentrations of testosterone to an average of 18,90 ± 1,50 nmol / l and decreased level of estradiol to an average of 104,0 ± 9,0 nmol / l. In addition, an analysis of the data showed that the most patients with laryngeal cancer were detected with the elevated prolactin levels. The average level of prolactin (255,2 ± 20 IU / l) was almost 1,3 times higher than the norm, and this increase indicates a deepening imbalance of sex steroids and the alteration of relationship between central and peripheral glands regulatory systems. Conclusion. During the study, which involved male patients with diagnosed laryngeal cancer, we revealed violations of endocrine-reproductive status at the peripheral organs that synthesize steroids, and also, at the level of central regulatory mechanisms of such synthesis, and the nature and severity of the observed changes were associated with patient age and tumor localization. Steroid dysfunction that aggravated pathological processes in the larynx, manifested in the form of combined hyperandrogenization in the most of the patients, absolute component of which was expressed in increasing the absolute level of testosterone in the blood and urine, and the relative in shifting the ratio between female and male sex steroids in favor of the latter.