ABSTRACT
Background: Incidence of bladder cancer has increased rapidly worldwide in the past few years. Environmental as well as genetic factors are involved in the etiology of bladder cancer. Glutathione S transferase mu 1 [GSTM1] and glutathione S transferase theta 1 [GSTT1] genes are two xenobiotic metabolizing genes in phase II of detoxification process
Aim: The current study was aimed to find out the association of different environmental factors and GSTM1 and GSTT1 gene polymorphisms with susceptibility to bladder cancer in Pakistani population
Method: Bladder cancer cases [236] and control blood samples [270] were screened using phenol chloroform method of DNA extraction followed by multiplex PCR
Results: With respect to age; bladder cancer was more prevalent in age >60 years and low grade tumors were more frequent than high grade tumors. Smokers had a significantly higher incidence rate of cancer; also family history of cancer was found to be strongly associated [P < 0.05] with bladder cancer. Commonly reported symptoms by the patients of bladder cancer were hematuria, lower urinary tract symptoms [LUTS] and flank pain. A larger number of patients had undergone surgery, chemotherapy and radiotherapy. Similarly GSTM1 [OR 2.24; CI 1.5-3.2; P = 0.0001] and GSTT1 [OR 2.9; CI 1.4-6.1; P = 0.002] gene deletion showed a highly significant association with bladder cancer. Simultaneous deletions of both GSTM1 and GSTT1 genes also showed highly significant association [OR 5.3; CI 2.1-13.1; P =0.0001] with cancer risk. No association was found when both of the two genes deletion was compared with bladder cancer among smokers
Conclusion: This study suggests that GSTM1 and GSTT1 gene polymorphisms may be associated with increased susceptibility toward bladder cancer in Pakistani population