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目的:应用全人群为基础的病例对照研究探讨GSTM1、GSTT1基因多态性和吸烟与膀胱癌危险性的关系。方法:采用多重PCR方法对404例正常对照和414例膀胱癌病例的基因组DNA进行GSTM1和GSTT1基因分型,应用非条件logistic回归分析方法进行统计分析。结果:与携带GSTM1(+)基因型者比,GSTM1(-)基因型的男、女性患膀胱癌危险性分别为1.66(95%CI:1.18～2.33)和1.08(95%CI:0.59～1.98)。同样携带GSTM1(-)基因型,吸烟者比不吸烟者患膀胱癌的危险性更加明显。与不吸烟且携带GSTM1(+)基因型男性比,GSTM1(-)基因型的目前吸烟者的OR值为2.99(95%CI:1.56～5.74),而携带GSTM1(-)基因型同时吸烟年限≥40年者OR为4.33(95%CI:2.14～8.73)。尽管女性吸烟例数较少,但携带GSTM1(-)基因型的吸烟女性患膀胱癌危险性显著高于不吸烟的GSTM1(+)基因型者,OR值为6.72(95%CI:1.69～26.80)。与不吸烟且携带GSTT1(+)基因型男性相比,携带GSTT1(-)基因型的吸烟者患男性膀胱癌危险的OR值为1.38(95%CI:0.79～2.42)。携带GSTT1(-)基因型的吸烟女性患膀胱癌危险性是不吸烟的GSTT1(+)基因型者的3.04倍(95%CI:0.77～12.01)。结论:GSTM1(-)基因型能显著增加男性患膀胱癌的风险,该基因型与吸烟可能有一定的联合作用。GSTT1基因型可能与上海市区男、女性膀胱癌无关。
Objective: To investigate the relationship between GSTM1, GSTT1 gene polymorphism and the risk of smoking and bladder cancer using a population-based case-control study. Methods: GSTM1 and GSTT1 genotypes were genotyped using multiplex PCR in genomic DNA of 404 normal controls and 414 cases of bladder cancer. Statistical analysis was performed using unconditional logistic regression analysis. RESULTS: The risk of bladder cancer in men and women with GSTM1 (-) genotype was 1.66 (95% CI: 1.18-2.33) and 1.08 (95% CI: 0.59-1.98, respectively) as compared with those carrying GSTM1 (+ ). The same GSTM1 (-) genotype, smokers than non-smokers risk of bladder cancer more obvious. The OR of current smokers with GSTM1 (-) genotype was 2.99 (95% CI: 1.56-5.74) compared with non-smoker and men with GSTM1 (+) genotype, while those with GSTM1 (- OR for ≥40 years was 4.33 (95% CI: 2.14 to 8.73). Despite the small number of women smokers, women with GSTM1 (-) genotype had a significantly higher risk of bladder cancer than non-smokers with GSTM1 (+) genotype, with an OR of 6.72 (95% CI: 1.69 to 26.80 ). The odds ratio for men with bladder cancer risk was 1.38 (95% CI: 0.79 to 2.42) in smokers with GSTT1 (-) genotype compared with non-smokers and men with GSTT1 (+) genotype. Smoking women with GSTT1 (-) genotype had a 3.04-fold (95% CI: 0.77 to 12.01) risk of bladder cancer compared with non-smoking GSTT1 (+) genotype. Conclusion: GSTM1 (-) genotype can significantly increase the risk of bladder cancer in men, which may have some combined effects with smoking. GSTT1 genotype may be unrelated to male and female bladder cancer in Shanghai.