UADTUpper Aero-Digestive Tract
UADTUniversity of Aberdeen Development Trust (Aberdeen, Scotland, UK)
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Sixty patients (54 male and six female subjects) attended ENT with histologically proven UADT malignancies [Figure 1].
Overall, the age distribution of UADT cancers was highest in the 60-69 years age group, with male:female ratio was 9:1.
The association of HPV with cancers of the UADT is also suspected.
Recently, in the United States, Gillison (44) showed that HPV is a causal factor for a distinct group of UADT cancers particularly in oropharyngeal cancers that occur more frequently in men than women, where oral sex appear to be the principal risk factor for HPV-associated oral cancers in adolescents (45).
In our first studies in UADT by using formalin-fixed and paraffin-embedded specimens (31,32), we detected HPV-DNA by GP5+/GP6+ primer pair for PCR (54) that amplified 150 base pair regions within L1, and the results were confirmed by southern blot analysis.
However, HPV vaccination in males may be a particularly important approach to prevent UADT cancer; most HPV-associated UADT cancers occur in men.
Professor of epidemiology Gary Macfarlane, who led the study, said: "Our findings confirmed that smoking tobacco, heavy alcohol consumption and a lack of fruit and vegetables in a person's diet remained the most important causes of cancers of the UADT." The five-year study, funded by a European Union grant, looked at 350 patients under the age of 50 with UADT cancers and 400 patients who did not have the diseases.
SCC is histologically the most common type comprising 95% of UADT tumours in Surveillance, Epidemiology, and End Results (SEER) registries in USA.
104 (66.67%) cases of UADT had mixed diet; whereas 52 (33.33%) patients were vegetarian.
Table 2 shows the distribution malignant cases of UADT under broad categories.
Table 3 shows the site wise distribution of Carcinomas of UADT. In 124 cases of carcinomas, most common carcinoma was Squamous cell carcinoma followed by verrucous carcinoma, poorly differentiated carcinoma and nasopharyngeal carcinoma.
The pathologic aspects of UADT cancers tend to be overlooked, because most of them are squamous cell carcinomas, which are not much attractive to both pathologists and clinicians.