线粒体环氧化物水解酶基因多态性和吸烟与膀胱癌发生和预后的关系

The Interaction between Microsomal Epoxide Hydrolase Polymorphism and Cumulative Cigarette Smoking in Carcinogenesis and Prognosis of Transitional Cell Carcinoma

目的探讨mEH基因多态性和吸烟与膀胱癌发生和预后的关系。方法采用二次PCR法检测膀胱尿路上皮癌组织及正常膀胱黏膜中mEH3及mEH4的基因多态性。结果 Logistic回归表明mEH活性及吸烟指数与膀胱癌的发生相关(mEH:χ2=6.59,P=0.009;吸烟指数:χ2=9.28,P=0.002),吸烟人群的膀胱癌易感性是非吸烟人群的3.72倍;mEH低活性者的膀胱癌易感性是mEH高活性者的4.01倍(OR=4.01,χ2=10.96,95%CI=1.77～9.48)。Cox风险比例回归结果表明,mEH活性和吸烟指数均与膀胱癌的预后关系密切(mEH:B=-1.436,P=0.015;吸烟指数:B=0.496,P=0.006)。结论膀胱癌的发生和预后与吸烟指数和mEH基因多态性关系密切,对于吸烟患者,mEH基因多态性可作为评估膀胱癌易感性和术后复发风险的一个辅助因素。

Objective To investigate whether the interaction between microsomal epoxide hydrolase（mEH）polymorphism and cumulative cigarette smoking is related with carcinogenesis of transitional cell carcinoma.Methods We collected the information of smoking status of 146 transitional cell carcinoma of bladder（TCCB）patients of our hospital from October 2004 to September 2006,and used PCR-RFLP to examine the polymorphism of mEH.Results According to the genotype of mEH and smoking index,patients were divided into very low activity group,high activity group,smoking group and no-smoking group.Logistic Regression showed mEH activity and smoking index were related with carcinogenesis of TCCB,（mEH：χ^26.59,P =0.009;smoking index：χ^29.28,P =0.002）,the susceptibility of bladder cancer in smokers was higher than in non-smokers（OR=4.01,χ^210.96,95%CI=1.77～9.48）.Cox regression showed both mEH and smoking index were related with poor prognosis of TCCB after surgery（mEH：B=-1.436,P =0.015;smoking index：B=0.496,P =0.006）.Conclusion mEH polymorphism and smoking index were related with carcinogenesis and prognosis of TCCB patients.To smokers,mEH polymorphism might be helpful to assess the hazard of susceptibility and recurrence of TCCB.