Abstract. Larynx cancer is the second most common type of cancer among all head and neck cancers. Deregulation of epigenetic effectors, including altered expression of histone methyltransferases from the MLL (mixed lineage leukemia) family, have been reported in many cancer types, yet little is known concerning their involvement in larynx cancer. Our objective was to determine the expression profile of MLL genes in larynx carcinoma and normal adjacent tissues and correlate this profile to tumor characteristics. We analyzed the expression profile of 5 MLL genes in 13 cases of larynx carcinoma and their adjacent non-tumor tissues using quantitative real-time PCR. MLL3 was significantly downregulated in tumor samples compared to their normal counterparts, and all MLL genes showed decreased expression in advanced tumors compared to tumors in the initial stage. Altered expression in a single MLL gene was associated with a similar alteration in the other MLL genes, revealing a strong correlation of expression in each individual patient. In conclusion, MLL genes may have similar transcriptional control, and decreased expression of these genes may contribute to larynx cancer progression.
IntroductionLarynx cancer is the second most common among all head and neck cancers, representing 2% of all malignant diseases worldwide, with 140,000 cases occurring every year (1). In Brazil alone, there is an estimated risk of 7 cases for every 100,000 men. Usually, affected men are over the age of 40 years. The registered incidence of this cancer in women is very low, accounting for less than 1 case for every 100,000 women. The disease can cause hoarseness, dysphagia, odynophagia, pain and other symptoms, according to the affected site (supraglottis, glottis, subglottis). Early detection leads to a better prognosis, enabling a cure in the majority of the cases, while patients with advanced tumors usually succumb to the disease (2). Tobacco is the main associated risk factor, with a positive correlation of duration and intensity of smoking and increased risk for larynx cancer. Other risk factors include alcohol consumption, occupational exposures and various dietary habits. Moreover, the risk for larynx cancer increases with the combined effect of smoking and alcohol consumption (2). Studies concerning the association of human papillomavirus (HPV) infection with larynx cancer are heterogeneous and inconclusive, yet HPV infection appears to be associated with the risk of larynx cancer, particularly with the high-risk type HPV16 (3).Almost all cancers occurring in the head and neck are squamous cell carcinomas. Although they have the same histological characteristics, they appear to have genetic and epigenetic differences, depending on the site. Allelic loss leading to the loss of function of tumor-suppressor genes are an important alteration in larynx tumors, such as the loss of heterozygosity (LOH) at 9p21, a region harboring the cell cycle regulator p16 gene (4). LOH at 8p was also found to be common in larynx and oral squamous cell...