Elevated Homocysteine, an Emerging Biomarker for Cervical Cancer, A Case-Controlled Study

Abstract

Background: Elevated homocysteine, an emerging biomarker for cervical cancer is amenable to treatment by cheap and effective nutritional interventions. Methods: From April 2012 through September 2012, a case-controlled study was performed in the Gynae oncology unit of Bangabandhu Sheikh Mujib Medical University (BSMMU) and the National Institute of Cancer Research and Hospital (NICR & H), in Dhaka, Bangladesh. The objectives were to measure the serum homocysteine levels in women with squamous cell carcinoma of the cervix and in normal controls. Fifty women with invasive squamous cell carcinoma and 50 normal controls were compared for demographic and socioeconomic differences. Blood was tested for homocysteine levels. Results: Among cases of cervical cancer, 82% had homocysteine level between 4.5-15 µmol/L & 14% had high homocysteine level (>15 µmol/L). Whereas in control group, 98% had homocysteine level between 4.5-15 µmol/L and 2% had homocysteine <4.5 µmol/L (low). High level of homocysteine (>15 µmol/L) was not observed in any patient in the control group. The mean homocysteine level in cervical cancer patients was also higher (10.88 ?mol/L) than that of controls (8.50 µmol/L) and this difference was statistically significant. Histological grade and clinical stage of cervical cancer did not correlate with serum homocysteine level. Conclusion: There is a difference in homocysteine levels in women with cervical cancer. Homocysteine, which is associated with nutritional deficiencies of fruits and vegetables, may play a role as a marker for or as a co-factor in malignant transformation of cervical squamous epithelium. Larger studies are needed to further study this association. However public awareness is important regarding the role of fresh vegetables and fruits containing vitamin B (folate-vitamin B9; vitamin B12; vitamin B6) to reduce homocysteine and its possible consequences of cancer prevention.