The relationship of serum folate and homocysteine with head and neck cancer: a systematic review and meta-analysis

Abstract

Abstract Context: Early diagnosis of Head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine in patients with HNSCC and healthy controls through a systematic review and consequent meta-analyses. Evidence Acquisition: The research question was is there a difference between serum folate and Hcy levels (O) of patients with HNSCC (E) with healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the Jan. 2000-Nov. 2023 period. The searched studies were screened based on the inclusion and exclusion criteria and after assessing the quality of the selected articles by the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random effect model. Several meta-analyses were carried out because the selected articles were not uniform concerning smoking habits. Results: Regardless of the smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups as compared to the control groups. Conclusions: The meta-analyses in this study showed the association of serum folate and homocysteine levels with HNSCC, which indicates their possible use as biomarkers for the early detection of HNSCC.