POLYMORPHISM AND SMOKING IN BLADDER CARCINOGENESIS

Objective To study the relationship between smoking, a cytochrome P-45 0 gene polymorphism and the development of bladder cancer. Patients an d methods The study comprised 126 patients with a diagnosis of bladder cancer from whom a full history was obtained. Genomic DNA was extract ed from blood sampled from each patient and genotyping of the CYP2D6 l ocus, the gene responsible for debrisoquine hydroxylase activity, was performed using a polymerase chain-reaction technique. Besults Of the 126 patients, 78% had a history of smoking. There was a relationship b etween the number of cigarettes smoked and the grade of the presenting bladder tumour; heavy smokers developed high-grade disease. There was a trend for those heterozygous at the CYP2D6 locus and with a history of smoking to develop more aggressive disease, but this trend did not reach statistical significance. Conclusion The link between smoking a nd bladder cancer was confirmed. Furthermore, the grade of the present ing tumour was related to the 'cigarette-years'. The CYP2D6 genotype m ay influence the type of bladder cancer that develops in smokers.