Abstract. N-acetyltransferase 2 (NAT2) is a key enzyme involved in the metabolism of xenobiotics and plays a significant role in the detoxification of numerous potential carcinogens. According to its acetylation status, NAT2 acetylator may be classified into two phenotypes, rapid and slow. Numerous studies have demonstrated that the polymorphisms of NAT2 were correlated with individual susceptibility to several malignant neoplasms, including head and neck carcinomas (HNC). However, the associations between the acetylator phenotypes and HNC risk in each study were not entirely consistent. To assess these associations more comprehensively, we performed a meta-analysis. In this meta-analysis, 16 eligible studies including 2,965 cases with HNC and 3,919 controls were identified by searching the databases of PubMed, Medline and the ISI Web of Knowledge. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were used to evaluate the association. No significant associations between the rapid acetylator phenotype in NAT2 and HNC risk were found either in the overall analysis (OR=0.98; 95% CI 0.83, 1.15; I 2 =57%; P heterogeneity =0.003) or in the subgroup analysis by ethnicity (for the Caucasian population, OR=1.03, 95% CI 0.85, 1.24, I 2 = 63%, P heterogeneity = 0.002; for other mixed populations, OR=0.78, 95% CI=0.61, 1.00, I 2 = 0%, P heterogeneity =0.47). In conclusion, this meta-analysis suggested that there is no association between the NAT2 phenotype and the risk of HNC.
IntroductionHead and neck carcinoma (HNC), arising from the sites of the oral cavity, oropharynx, hypopharynx and larynx, is the sixth most common type of cancer worldwide (1). It is characterized by a moderately low survival rate, a high recurrence rate, and a high rate of second primary malignancy (2). In 2009, approximately 49,260 new cases (35,530 males and 13,730 females) of HNC were diagnosed in the USA, and 11,480 deaths occurred (8,300 males and 3,180 females) (1). Present evidence has proven that numerous factors contribute to the risk of squamous cell carcinoma of the head and neck, including tobacco use, alcohol consumption (3), viral infection (4) and genetic polymorphisms (5). In particular, tobacco smoking and alcohol consumption account for approximately 80% of HNC cases (6,7). However, it is worth noting that only a fraction of smokers and alcohol consumers develop HNC. This phenomenon suggests that host factors, including genetic variation, contribute to the inter-individual variation in the susceptibility to HNC.Numerous procarcinogens are known to exist in tobacco, including polycyclic aromatic hydrocarbons (PAHs), aromatic and heterocyclic amines; nitroso-compounds in smoking tobacco; and nitrosamines, aromatic and heterocyclic amines in smokeless tobacco. Most of these carcinogens generally undergo bioactivation and inactivation by phase Ⅰ and Ⅱ enzymes, respectively. The phase Ⅱ enzymes, including Glutathione S-transferases (GSTs) and N-acetyltransferase (NAT), contribute to the detoxification metabolism. Human NAT compr...