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. 2023 Sep;149(11):9349-9359.
doi: 10.1007/s00432-023-04850-8. Epub 2023 May 21.

Digit ratio (2D:4D), laryngeal cancer and vocal fold leukoplakia

Wioletta Pietruszewska  1 , Joanna Morawska  1 , John T Manning  2 , Aneta Sitek  3 , Bogusław Antoszewski  4 , Anna Kasielska-Trojan  5
Affiliations

Digit ratio (2D:4D), laryngeal cancer and vocal fold leukoplakia

Wioletta Pietruszewska et al. J Cancer Res Clin Oncol. 2023 Sep.

Abstract

Background: To date, there are no studies that have analyzed the possible influence of exposure to prenatal sex hormones on the risk of laryngeal cancer (LC) and premalignant laryngeal lesion-vocal fold leukoplakia (VFL). Digit ratio (2D:4D) is suggested to be a proxy of prenatal sex hormone exposure.

Objective: To examine 2D:4D in patients with LC and clarify if it could add to the verified risk factors in estimating the overall risk of LC.

Methods: 511 subjects participated in the study. The study group included 269 patients: with LC (N = 114, 64 men) and VFL (N = 155, 116 men). Controls included 242 healthy individuals (66.40 ± 4.50 years (106 men)).

Results: Predictive models estimating the risk of VFL and LC in women, based solely on predictors like smoking and alcohol consumption had a lower area under the ROC curve (AUC) than the model with left 2D:4D. AUC for the model estimating the likelihood of VFL increased from 0.83 to 0.85, and for LC from 0.76 to 0.79.

Conclusions: Low left 2D:4D may be associated with an increased risk of developing leukoplakia and laryngeal cancer in women. In the case of laryngeal cancer, left 2D:4D may serve as additional variable (to other known risk factors, such as smoking and/or alcohol consumption), which can improve cancer risk prediction.

Keywords: Digit ratio; Laryngeal cancer; Leukoplakia; Risk factors.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose

Figures

Fig. 1
Fig. 1
Comparison of ROC curves for models estimating the probability of leukoplakia in women
Fig. 2
Fig. 2
Comparison of ROC curves for models estimating the probability of laryngeal cancer in women
See this image and copyright information in PMC

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