Adipocyte-fatty Acid Binding Protein is Associated with Clinical Stage and Inflammatory Markers in Head and Neck Cancer Patients

Abstract

Background: Head and neck carcinomas are the fifth most common cancer worldwide. Squamous cell carcinoma of the head and neck (HNSCC) is a highly heterogeneous tumor. Additional clinical and biological factors are needed to improve tumor diagnosis and to identify subsets of patients with unfavorable outcome. Several recent studies showed that cancer cells stimulate lipid metabolism during tumor progression. Studies have revealed the involvement of fatty acid binding proteins (FABPs) expression in the pathology of different diseases including malignant neoplasms. It has been suggested that the immune changes occurring in the tumour environment determine its aggressive behavior, these changes may affect the prognosis and treatment outcomes in patients with cancer. The tumor necrosis factor (TNF-α) is a proinflammatory cytokine that expressed in HNSCC has a possible role in cancer invasiveness and the risk of metastases. C-reactive protein (C-RP) is an acute-phase protein that increases in acute, chronic inflammations, infections and tissue damages. It has been suggested that C-RP also is elevated in cancers. Objective: The aim of this study was to determine whether the plasma levels of A-FABP are linked to head and neck cancer, inflammatory markers (TNF-α and C-RP) and tumor characteristics. Subjects and Methods: The present study was conducted on 50 healthy individuals and 50 newly diagnosed patients with histologically confirmed HNSCC that accepted to participate. Patients with distant metastases at time of diagnosis, hepatic insufficiency, active autoimmune or coexisting infectious disease were excluded. The study included HNSCC patients with tumours ranged from stage I-IVA (cT1-4a, N0-2, M0). Age, sex, date of diagnosis, tumor site, grade, TNM stage and treatment were recorded. Results: Statistical analysis of the results showed that the mean values of plasma A-FABP, TNF-α and C-RP in HNSCC patients before treatment were significantly higher than that in control group. The plasma levels of the three biomarkers were significantly decreased after treatment than their corresponding values before treatment and plasma C-RP levels became within the normal control values. The risk for head and neck cancer is significantly increased in higher plasma A-FABP group compared with lower levels group. A significant positive correlation was found between plasma A-FABP and both TNF-α and C-RP. There was also a significant correlation observed between plasma A-FABP levels and clinical stage. On the other hand, no correlation was found between plasma levels of TNF-α or C-RP and clinical stage. The three biomarkers were not correlated with other paramters like patient's age, sex, BMI or smoking status. Conclusions: The findings in the present study suggested elevated levels of A-FABP, TNF-α and CRP in HNSCC patients before treatment that significantly decreased after treatment. Higher plasma A-FABP is associated with clinical stage and risk of HNSCC.