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Background: E-cadherin is a cell structural protein that has a pivotal role in cell-cell adhesion and epithelial development. Up to now, loss of activity of E-cadherin is believed to contribute to progression in several neoplastic diseases of epidermoid origin including nasopharyngeal carcinomas (NPC) by increasing invasion and proliferation. Besides, functional genetic variations in the promoter region of the E-cadherin gene have been associated with susceptibility to several neoplasms. In the current study we investigated the impact of the functional C/A genetic polymorphism at -160 from transcriptional start site of the E-cadherin gene promoter on susceptibility and prognosis in NPC., Methods: A PCR and restriction fragment length polymorphism analysis was used to determine the variation of the -160C/A promoter region in a Tunisian population consisting of 162 NPC patients and 140 age matched healthy controls. Associations of the genetic markers with the clinicopathological parameters and the rates of the nasopharyngeal carcinoma-specific overall survival and the disease-free survival were also assessed., Results: A significantly increased risk of NPC was observed for carriers of E-cadherin -160A allele (OR=2.02; P=0.008). AA and CA genotypes entailed a 4.12 and 1.8 fold high risks, respectively for NPC compared to the CC genotype. Additionally, an association was ascertained between the E-cadherin polymorphism and the young age onset of NPC., Conclusions: This is the first report on the studies of functional E-cadherin polymorphisms in NPC and our preliminary results suggest that the -160 C/A promoter polymorphism is associated with increased risk of nasopharyngeal carcinoma in the Tunisian population, especially in young patients., (Copyright 2010 Elsevier B.V. All rights reserved.)