The Role of Estrogen and Estrogen Receptors in Head and Neck Tumors

Simple Summary Head and neck tumors (HNTs) represent a diverse group of malignancies that originate from the lining tissue of organs in the upper parts of the respiratory and digestive tracts. Given that these include parts of the body that enable breathing, speech, and feeding, these tumors cause a great reduction in the quality of life. The main risk factors are consumption of tobacco products and alcohol, as well as infection with human papillomaviruses. However, regardless of the risk factors, men have a significantly higher risk of developing HNTs than women. It is, therefore, presumed that exposure to the female sex hormone estrogen in women could provide protection against the development of those tumors in women. In this scientific literature survey, we provide a comprehensive overview of the role of estrogen and its receptors in HNTs and assess the possible benefits of therapy with either exogenous estrogen or anti-estrogens.Abstract Head and neck squamous cell carcinoma (HNSCC) is the most common histological form of head and neck tumors (HNTs), which originate from the epithelium of the lips and oral cavity, pharynx, larynx, salivary glands, nasal cavity, and sinuses. The main risk factors include consumption of tobacco in all forms and alcohol, as well as infections with high-risk human papillomaviruses or the Epstein-Barr virus. Regardless of the etiological agent, the risk of developing different types of HNTs is from two to more than six times higher in males than in females. The reason for such disparities probably lies in a combination of both biological and psychosocial factors. Therefore, it is hypothesized that exposure to female sex hormones, primarily estrogen, provides women with protection against the formation and metastasis of HNTs. In this review, we synthesized available knowledge on the role of estrogen and estrogen receptors (ERs) in the development and progression of HNTs, with special emphasis on membrane ERs, which are much less studied. We can summarize that in addition to epidemiologic studies unequivocally pointing to the protective effect of estrogen in women, an increased expression of both nuclear ERs, ER alpha, and ER beta, and membrane ERs, ER alpha 36, GPER1, and NaV1.2, was present in different types of HNSCC, for which anti-estrogens could be used as an effective therapeutic approach.