Assessment of association between ABO blood groups and laryngeal cancer among Iranian population.
ABO blood groups are considered as genetic factors that might play a role in the pathogenesis of various diseases e.g. neoplastic ones (10). Blood Group A has been reportedly higher among various cancers including neurologic tumors, salivary gland, colon, uterus, ovary, pancreas, kidney, bladder, and cervix. Moreover, O blood group is demonstrated to be associated with skin and melanoma (2).
Evidence regarding the associations between ABO blood groups and laryngeal cancers is controversial in various ethnicities. Moreover, there is no study addressing this important issue among Iranian population. The present study aimed to investigate the associations of laryngeal cancers and their TNM stage with ABO blood groups southwest of Iran.
Patients and Methods
Data of all patients with laryngeal cancer referred to Ahvaz Imam-Khomeini Hospital (Ahvaz, Iran) during 2003 to 2013 were studied. Demographic information, ABO blood groups and cancer stages were recorded after obtaining ethical clearance. This study was approved by the ethics committee of Jundishapur University of Medical Sciences. Ethnical, age, and sex matched control subjects were obtained from healthy blood donors.
Continuous variables are reported as mean [+ or -] SD. Categorical data are expressed as frequencies and percentages with 95% confidence intervals, and were analyzed by IBM[TM] SPSS version 20. Chi-square, Fisher's exact, and Monte Carlo exact tests were conducted were needed. Binary logistic regression was performed to elucidate the risk of each blood group for laryngeal cancer. P-values less than 0.05 were considered statistically significant.
Sixty-six patients with laryngeal cancer with mean age of 61.7 years (SD = [+ or -] 12.42 years) were enrolled. Fifty nine patients were male (89.39%) and the other female. One-hundred and forty eight healthy individuals were studied as controls.
Table 1 shows the frequencies of blood groups among laryngeal cancer patients and healthy controls. No significant association was found between ABO blood groups and laryngeal cancer ([chi square]=3.78, p=0.278). In addition, we did not observe a significant association between laryngeal cancer and Rh blood groups ([chi square] = 1.198, p=0.351).To assess whether sufficient sample size is obtained, we calculated the observed power. We found 99.37% and 76.89% power for ABO and Rh blood groups, respectively. Furthermore, we found no significant association between TNM staging levels and blood groups.
This is the first study assessing the associations of ABO/Rh blood groups and laryngeal cancer in Iranian population. This case-control study with sufficient sample size does not show a significant association between ABO/Rh blood groups and laryngeal cancer.
Evidence regarding the associations between ABO blood groups and laryngeal cancer has been controversial among populations. While Singh et al found that laryngeal cancer is more prevalent in blood group B in Indian population (2), Adam et al reported a higher prevalence of laryngeal cancer among patients with blood Group A (6). No specific reasons have been proposed for such associations. However, the overall higher prevalence of blood group A in head and neck cancers justified to be associated with the precursor H antigen which is converted to A and B antigen (2,3). Actually H antigen has been demonstrated to be protective factor for oral cancers, which is in its higher amounts among O blood group (2,3). However this association has not been confirmed as an etiological relationship considering the fact that it might be due to genes closely associated with blood groups, like p56 gene mutation which is found to be associated with higher risk of oral cancer (11). Another study in Poland showed that A2B blood group was significantly more prevalent among patients with epiglottis cancer and laryngeal cancer compared to 22,422 healthy individuals living in South Poland12. However, a more recent study in Poland reported no significant associations between ABO blood groups and laryngeal cancer, as compared to 5168 blood donors living in South Poland (13). We believe such controversies can be attributed to non-homogenous population selection and their various statistical power mainly due to different sample sizes of control group.
In this study we faced some limitations as we could not perform genetic mapping of the subjects. More prospective and large scale studies might be helpful to confirm the findings of this study.
In summary, we do not report significant associations between ABO/Rh blood groups and laryngeal cancer in Iranian population, obtained by this case control study with high statistical power.
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Nader Saki , Vita Darakhshandeh , Somayeh Araghi , Sara Lotfi  and Soheila Nikakhlagh  *
 Department of Otolaryngology, Head and Neck Surgery, Hearing and Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
 Resident of Otolaryngology, Hearing & Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
(Received: 20 July 2015; accepted: 03 September 2015)
* To whom all correspondence should be addressed. Fax: +986132921838; E-mail: Ahvaz.firstname.lastname@example.org
Table 1. The frequencies of blood groups between cases of laryngeal cancer and healthy controls Blood Groups Healthy Laryngeal p-value ABO groups Controls Cancer Count(%) Count (%) A 37 (25.0%) 19 (31.1%) 0.986 B 44 (29.7%) 13 (21.3%) 0.172 AB 18 (12.2%) 4 (6.6%) 0.169 O 49 (33.1%) 25 (41.0%) referent Rh groups Rh- 10 (6.8%) 2 (3.0%) referent Rh+ 138 (93.2%) 64 (97.0%) 0.287 Blood Groups power OR (95% CI) ABO groups ([dagger]) A 99.37% 1.006 (0.483-2.096) B 0.579 (0.264-1.268) AB 0.436 (0.133-1.426) O 1 Rh groups Rh- 76.89% 1 Rh+ 2.319 (0.494-10.891) OR, Odds Ratio; CI, Confidence Interval; ([dagger]) we used the formula power = 1 - [[chi square]'.sub.dx,[lambda]] a where [[chi square]'.sub.dx,[lambda]] is a left-tail non-central Chi-square distribution with degree of freedom (df) and non-centrality parameter [lambda] = [Nw.sup.2] = N x ([[summation].sup.m.sub.i=1] ([([p.sub.0i] - [p.sub.1i]).sup.2]/[p.sub.0i])); performed by IBM[TM] SPSS version 20 compute variable formula (1-NCDF.CHISQ (quant, df, nc).
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|Author:||Saki, Nader; Darakhshandeh, Vita; Araghi, Somayeh; Lotfi, Sara; Nikakhlagh, Soheila|
|Publication:||Journal of Pure and Applied Microbiology|
|Date:||Sep 1, 2015|
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