Occupational exposure to trichloroethylene and risk of non-Hodgkin lymphoma and its major subtypes: a pooled InterLymph [correction of IinterLlymph] analysis

OBJECTIVES

We evaluated the association between occupational exposure to trichloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL) in a pooled analysis of four international case-control studies.

METHODS

Overall, the pooled study population included 3788 NHL cases and 4279 controls. Risk of NHL and its major subtypes associated with TCE exposure was calculated with unconditional logistic regression and polytomous regression analysis, adjusting by age, gender and study.

RESULTS

Risk of follicular lymphoma (FL), but not NHL overall or other subtypes, increased by probability (p=0.02) and intensity level (p=0.04), and with the combined analysis of four exposure metrics assumed as independent (p=0.004). After restricting the analysis to the most likely exposed study subjects, risk of NHL overall, FL and chronic lymphocytic leukaemia (CLL) were elevated and increased by duration of exposure (p=0.009, p=0.04 and p=0.01, respectively) and with the combined analysis of duration, frequency and intensity of exposure (p=0.004, p=0.015 and p=0.005, respectively). Although based on small numbers of exposed, risk of all the major NHL subtypes, namely diffuse large B-cell lymphoma, FL and CLL, showed increases in risk ranging 2-3.2-fold in the highest category of exposure intensity. No significant heterogeneity in risk was detected by major NHL subtypes or by study.

CONCLUSIONS

Our pooled analysis apparently supports the hypothesis of an increase in risk of specific NHL subtypes associated with occupational exposure to TCE.

Leukemia-related chromosomal loss detected in hematopoietic progenitor cells of benzene-exposed workers

Benzene exposure causes acute myeloid leukemia and hematotoxicity, shown as suppression of mature blood and myeloid progenitor cell numbers. As the leukemia-related aneuploidies monosomy 7 and trisomy 8 previously had been detected in the mature peripheral blood cells of exposed workers, we hypothesized that benzene could cause leukemia through the induction of these aneuploidies in hematopoietic stem and progenitor cells. We measured loss and gain of chromosomes 7 and 8 by fluorescence in situ hybridization in interphase colony-forming unit-granulocyte-macrophage (CFU-GM) cells cultured from otherwise healthy benzene-exposed (n=28) and unexposed (n=14) workers. CFU-GM monosomy 7 and 8 levels (but not trisomy) were significantly increased in subjects exposed to benzene overall, compared with levels in the control subjects (P=0.0055 and P=0.0034, respectively). Levels of monosomy 7 and 8 were significantly increased in subjects exposed to <10 p.p.m. (20%, P=0.0419 and 28%, P=0.0056, respectively) and ≥ 10 p.p.m. (48%, P=0.0045 and 32%, 0.0354) benzene, compared with controls, and significant exposure-response trends were detected (P(trend)=0.0033 and 0.0057). These data show that monosomies 7 and 8 are produced in a dose-dependent manner in the blood progenitor cells of workers exposed to benzene, and may be mechanistically relevant biomarkers of early effect for benzene and other leukemogens.

Coal combustion and lung cancer risk in XuanWei: a possible role of silica?

BACKGROUND

XuanWei County, Yunnan province, has the highest lung cancer mortality rates among men and women in China. The high mortality has been linked to the use of smoky (bituminous) coal for heating and cooking. Research to date has suggested that exposure to polycyclic aromatic hydrocarbons (PAHs) is one of the main contributors to the observed risk. More recently exposure to crystalline silica has been suggested as another contributing factor.

METHODS

We used data of indoor benzo[a]pyrene (BaP) and silica level and lung cancer mortality at the communal level from previous reports to discuss etiological hypotheses on the lung cancer epidemics in XuanWei County.

RESULTS

We estimated that PAH exposure as measured by benzo[a]pyrene (BaP) can explain a significant part of the excess risk but not fully (Odd Ratio (OR) 3 as compared to an observed OR = 8 for smoky coal users versus smokeless coal users). This leaves open the possibility of other contributing exposures. Exposure to crystalline silica however would likely only result in an increased risk (OR) of less than 1.5 and as such silica seems not to be the main exposure of interest. However, this does not exclude that risks are present because of the specific physic-chemical characteristics of the silica in smoky coal or that there is an interaction between silica and PAH exposures.

CONCLUSION

More detailed exposure assessment of indoor air pollution due to the use of smoky coal and subsequent linkage on an individual level to ongoing epidemiological studies should provide more insight in the etiology of lung cancer in this region.

Differential effects of smoking on lung cancer mortality before and after household stove improvement in Xuanwei, China

Background:

In Xuanwei County, Yunnan Province, China, lung cancer mortality rates in both males and females are among the highest in China.

Methods:

We evaluated differential effects of smoking on lung cancer mortality before and after household stove improvement with chimney to reduce exposure to smoky coal emissions in the unique cohort in Xuanwei, China. Effects of independent variables on lung cancer mortality were measured as hazard ratios and 95% confidence intervals using a multivariable Cox regression model that included separate time-dependent variables for smoking duration (years) before and after stove improvement.

Results and conclusion:

We found that the effect of smoking on lung cancer risk becomes considerably stronger after chimney installation and consequent reduction of indoor coal smoke exposure.

Retrosigmoid keyhole approach to the posterior cranial fossa: an anatomical and clinical study

The purpose of this study is to describe the microsurgical anatomic features, as well as the operative technique for the retrosigmoid keyhole (RSK) approach to the posterior cranial fossa. In the anatomical study, 6 cadaveric heads were dissected to simulate the RSK approach. In the clinical study, the records for 15 patients treated using the RSK approach were examined. We found both conventional and RSK procedures expose the regions superior to the anterolateral margin of the tentorium, inferior to the foramen magnum, and medial to the anterolateral pons and medulla. Clinically, total removal was achieved in 13 out of 15 patients. We feel it is a safe, succinct, and minimally invasive alternative to the traditional retrosigmoid approach in selected patients.

Application of OMICS technologies in occupational and environmental health research; current status and projections

OMICS technologies are relatively new biomarker discovery tools that can be applied to study large sets of biological molecules. Their application in human observational studies (HOS) has become feasible in recent years due to a spectacular increase in the sensitivity, resolution and throughput of OMICS-based assays. Although, the number of OMICS techniques is ever expanding, the five most developed OMICS technologies are genotyping, transcriptomics, epigenomics, proteomics and metabolomics. These techniques have been applied in HOS to various extents. However, their application in occupational environmental health (OEH) research has been limited. Here, we will discuss the opportunities these new techniques provide for OEH research. In addition we will address difficulties and limitations to the interpretation of the data that is generated by OMICS technologies. To illustrate the current status of the application of OMICS in OEH research, we will provide examples of studies that used OMICS technologies to investigate human health effects of two well-known toxicants, benzene and arsenic.

Association between genetic variants in VEGF, ERCC3 and occupational benzene haematotoxicity

INTRODUCTION

Benzene is an established human haematotoxin, with substantial interindividual variation in benzene-induced toxicity.

METHODS

To further examine if genetic variation contributes to benzene haematotoxicity, we analysed 1023 tagSNPs in 121 gene regions important for benzene metabolism, haematopoiesis, leukaemia and lymphoma among 250 workers exposed to benzene and 140 unexposed controls in a cross-sectional study carried out in China. Linear regression was used to analyse the relationship between genetic polymorphisms and total white blood cell (WBC) count and its subtypes, adjusting for potential confounders and occupational exposure to benzene and toluene among exposed workers. The minp test assessed the association on the gene region level. The false discovery rate method was used to control for multiple comparisons.

RESULTS

VEGF (minp = 0.0030) and ERCC3 (minp = 0.0042) were the most significantly associated gene regions with altered WBC counts among benzene-exposed workers, after accounting for multiple comparisons. Highly significant changes were also found for WBC subtype counts, including granulocytes, CD4+ T cells and lymphocytes for VEGF and granulocytes and NK cells for ERCC3. Further, in workers exposed to <1 ppm, a SNP in VEGF was associated with changes in WBC and granulocyte counts, and SNPs in ERCC3 were associated with changes in WBC, NK cell and granulocyte counts.

DISCUSSION

Our findings suggest that genetic variation in VEGF, which plays an important role in blood vessel growth, and ERCC3, which is a member of the DNA repair pathway and is responsible for repairing bulky DNA adducts formed by chemicals, may contribute to individual susceptibility to benzene-induced haematotoxicity at relatively low levels of benzene exposure.

Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917–1951 and residing in Xuanwei in 1976. Of the 42 422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46–0.82) and female participants (HR=0.41, 95% CI=0.29–0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

Identification of two sterol carrier protein-2 like genes in the yellow fever mosquito, Aedes aegypti

Two genes encoding sterol carrier protein-2 like proteins are identified from fourth instar cDNAs of the yellow fever mosquito, Aedes aegypti. The predicted AeSCP-2like1 (AeSCP-2L1) and AeSCP-2like2 (AeSCP-2L2) proteins are small, acidic and lacking the peroxisomal targeting sequence at the C-termini. Purified recombinant AeSCP-2L1 and -2L2 bind to cholesterol with a Kd of 5.4 x 10(-6) M and 2.6 x 10(-6) M, respectively. The Kd values of AeSCP-2L1 and -2L2 to palmitic acid are 3.7 x 10(-7) M and 2.6 x 10(-7) M, respectively. Both genes are expressed predominantly in gut tissues. The transcripts of the AeSCP-2L1 gene are only detected in larval stages, whereas AeSCP-2L2 is expressed in larval and adult stages. AeSCP-2L2 transcription increases within 5 h after a bloodmeal and stays at high levels during vitellogenesis. In in vitro larval gut tissue cultures, AeSCP-2L1 transcripts were increased in the presence of juvenile hormone III, whereas AeSCP-2L2 mRNA levels increased in the presence 20-hydroxylecdysone. The results suggest that transcription of AeSCP-2L1 and -2L2 genes are regulated differently through the mosquito life cycle.

Two-sample comparison based on prediction error, with applications to candidate gene association studies

To take advantage of the increasingly available high-density SNP maps across the genome, various tests that compare multilocus genotypes or estimated haplotypes between cases and controls have been developed for candidate gene association studies. Here we view this two-sample testing problem from the perspective of supervised machine learning and propose a new association test. The approach adopts the flexible and easy-to-understand classification tree model as the learning machine, and uses the estimated prediction error of the resulting prediction rule as the test statistic. This procedure not only provides an association test but also generates a prediction rule that can be useful in understanding the mechanisms underlying complex disease. Under the set-up of a haplotype-based transmission/disequilibrium test (TDT) type of analysis, we find through simulation studies that the proposed procedure has the correct type I error rates and is robust to population stratification. The power of the proposed procedure is sensitive to the chosen prediction error estimator. Among commonly used prediction error estimators, the .632+ estimator results in a test that has the best overall performance. We also find that the test using the .632+ estimator is more powerful than the standard single-point TDT analysis, the Pearson's goodness-of-fit test based on estimated haplotype frequencies, and two haplotype-based global tests implemented in the genetic analysis package FBAT. To illustrate the application of the proposed method in population-based association studies, we use the procedure to study the association between non-Hodgkin lymphoma and the IL10 gene.

Meta- and pooled analysis of GSTT1 and lung cancer: a HuGE-GSEC review

Lung cancer is the most common malignancy in the Western world, and the main risk factor is tobacco smoking. Polymorphisms in metabolic genes may modulate the risk associated with environmental factors. The glutathione S-transferase theta 1 gene (GSTT1) is a particularly attractive candidate for lung cancer susceptibility because of its involvement in the metabolism of polycyclic aromatic hydrocarbons found in tobacco smoke and of other chemicals, pesticides, and industrial solvents. The frequency of the GSTT1 null genotype is lower among Caucasians (10-20%) than among Asians (50-60%). The authors present a meta- and a pooled analysis of case-control, genotype-based studies that examined the association between GSTT1 and lung cancer (34 studies, 7,629 cases and 10,087 controls for the meta-analysis; 34 studies, 7,044 cases and 10,000 controls for the pooled analysis). No association was observed between GSTT1 deletion and lung cancer for Caucasians (odds ratio (OR) = 0.99, 95% confidence interval (CI): 0.87, 1.12); for Asians, a positive association was found (OR = 1.28, 95% CI: 1.10, 1.49). In the pooled analysis, the odds ratios were not significant for either Asians (OR = 0.97, 95% CI: 0.83, 1.13) or Caucasians (OR = 1.09, 95% CI: 0.99, 1.21). No significant interaction was observed between GSTT1 and smoking on lung cancer, whereas GSTT1 appeared to modulate occupational-related lung cancer.

Design and Microsurgical Anatomy of the Retrosigmoid-Retrocondylar Keyhole Approach without Occipital Condyle Removal

OBJECTIVE

The goal of this study was to design a new retrosigmoid-retrocondylar keyhole approach based on the minimally invasive keyhole idea and to explore its feasibility and indications, which can be regarded as the base of this keyhole approach in clinical use.

METHODS

8 adult cadaveric heads fixed in formalin and with intracranial vessels perfused by colored latex were used in this study. To search for the most suitable length and shape of the skin incision, we examined two kinds of incision (a longitudinal "S" shape and a straight one) and two lengths (5 cm and 7 cm, respectively). Due to the complexity and thickness of the suboccipital muscles, two ways of muscle dissection were compared: 1) the muscles were incised perpendicularly in layers; 2) the muscles were detached and reflected in layers. A 3-cm diameter retrosigmoid-retrocondylar bone flap was made with a craniotome. Many anatomic structures could be observed under the microscope when the cerebellar hemisphere was retracted. After comparing and balancing the above steps in all specimens, a feasible, duplicable retrosigmoid-retrocondylar keyhole approach was devised.

RESULTS

The proper incision of the retrosigmoid-retrocondylar keyhole approach was a longitudinal "S" shaped skin incision about 7 cm in length with its superior border 2 cm behind the middle point of mastoid and inferior margin at the level of C-2. The method of detachment and reflection of occipital muscles was superior to the method of cutting them perpendicularly. By means of adjusting the head position and the angle of microscope, the ipsilateral vertebral artery, posterior inferior cerebellar artery, anterior inferior cerebellar artery, VII, VIII, IX, X, XI, XII cranial nerves and the ventral lateral aspect of medulla oblongata were exposed via this keyhole approach.

CONCLUSIONS

The novel retrosigmoid-retrocondylar keyhole approach has practical value for clinical applications. With the techniques of modern microsurgery, several diseases such as an aneurysm situated at the vertebral artery or the posterior inferior cerebellar artery, a small hypoglossal neurinoma and tumor located at the ventral lateral aspect of the medulla oblongata, may be operated via this retrosigmoid-retrocondylar keyhole approach without drilling the occipital condyle.

Aedes aegypti phosphohexomutases and uridine diphosphate-hexose pyrophosphorylases: comparison of primary sequences, substrate specificities and temporal transcription

Phosphohexomutases reversibly catalyse the transfer of the phosphate group of a glycosyl phosphate between the C6 and C1 positions, and uridine diphosphate (UDP)-hexose pyrophosphorylases catalyse the synthesis of UDP-hexose from uridine triphosphate (UTP) and hexose-1-phosphate. Both enzyme families are essential for nucleoside diphosphate hexose biosynthesis and are therefore critical for various physiological functions in the midgut of mosquitoes after a blood meal. We cloned and sequenced three phosphohexomutase and two UDP-hexose pyrophosphorylase cDNAs from Aedes aegypti. The products of the cDNAs were expressed and substrate specificities were examined. Herein we describe Ae. aegypti phosphoglucomutase 1, phosphoglucomutase 2, phosphoacetylglucosamine mutase, UDP-glucose pyrophosphorylase, and UDP-N-acetylglucosamine pyrophosphorylase. Transcripts of the genes expressing the enzymes are constitutively present in all life stages and blood-feeding does not seem to influence transcript abundance.

Functional analysis of AeSCP-2 using gene expression knockdown in the yellow fever mosquito, Aedes aegypti

The effect of gene expression knockdown was used to study the function of the sterol carrier protein-2 (AeSCP-2) in the yellow fever mosquito, Aedes aegypti. Injection of small double stranded AeSCP-2 RNAs into mosquito larvae resulted in the knockdown of gene products. The lack of AeSCP-2 in larvae coincided with a reduction in accumulated cholesterol in pupae, supporting the hypothesis that AeSCP-2 may be involved in cholesterol uptake in mosquito larvae. Knockdown of AeSCP-2 caused a high mortality rate in developing adult and reduced egg viability. Results from this study indicate that AeSCP-2 is important for adult development and for the viability of the eggs.

Expression of a sterol carrier protein-x gene in the yellow fever mosquito, Aedes aegypti

The sterol carrier protein-x (SCP-x), a peroxisomal thiolase/nonspecific lipid binding protein, was characterized in the yellow fever mosquito, Aedes aegypti. The Aedes aegypti SCP-x (AeSCP-x) has 83% and 75% similarities to Drosophila and mammalian SCP-x, respectively. However, the AeSCP-x gene did not produce multiple transcripts, which is characteristic of the vertebrate SCP-x gene. Levels of AeSCP-x transcription were higher in larvae and pupae. Gut tissue showed the highest level of AeSCP-x mRNA in larvae. In adults, low levels of AeSCP-x transcription were detected in both sexes. Polyclonal antibodies against the sterol carrier protein-2 (SCP-2) domain of AeSCP-x detected two proteins of 62 kDa and 13 kDa. The results indicate that AeSCP-x is proteolytically cleaved after translation to produce a smaller protein that contains only the SCP-2 domain, which is similar to post-translational modification of the vertebrate's SCP-x to produce multiple products.

Stage-specific expression of two actin genes in the yellow fever mosquito, Aedes aegypti

Abstract The expression patterns of two muscle-specific actin genes were studied in the yellow fever mosquito, Aedes aegypti. The coding sequence of AeAct-2 exhibits between 82 and 85% similarity with coding sequences of the Drosophila melanogaster and predicted Anopheles gambiae actin genes. The transcription of the AeAct-2 gene was differentially regulated during developmental stages with higher levels of expression in larvae and lower levels in pupae and adults. The AeAct-2 gene is mainly expressed in the head and body wall tissues. Transcripts of the AeAct-3 gene are not detectable in larvae until late 4th instar and the level increased in male pupae and early male adults. The main site of expression of the AeAct-3 gene was the thoracic tissue. Thus, AeAct-3 is the first reported male-specific actin gene in mosquitoes.

Isolation and expression of a sterol carrier protein-2 gene from the yellow fever mosquito, Aedes aegypti

Trafficking of cholesterol in insects is a very important process due to the fact that insects depend on dietary cholesterol to fulfil their physiological needs. We identified a putative mosquito sterol carrier protein-2 (SCP-2) cDNA from fourth instar subtracted cDNA library. The AeSCP-2 protein has high degree homology in the sterol transfer domain to both rat and human SCP-2. Transcripts of AeSCP-2 in fourth instars were detected strongly in the midgut, and weakly in the head and hindgut. In the early pupae, AeSCP-2 transcription was observed in the thorax, head and body wall of abdomen, but not in the gut. The interaction of mosquito sterol carrier protein-2 (AeSCP-2) with cholesterol was examined. The Kd of purified recombinant AeSCP-2 to cholesterol was 5.6 +/- 0.6 x 10-9 m using radiolabelled cholesterol-binding assay. The results suggest that AeSCP-2 has high affinity to cholesterol and may function as a carrier protein in mosquitoes.

Glutathione S-transferase genotypes and stomach cancer in a population-based case-control study in Warsaw, Poland

Glutathione S-transferases are important in the detoxification of a wide range of human carcinogens. Previous studies have shown inconsistent associations between the GSTT1 and GSTM1 null genotypes and stomach cancer risk. We investigated the relationship between these and related genotypes and stomach cancer risk in a population-based case-control study in Warsaw, Poland, where stomach cancer incidence and mortality rates are among the highest in Europe. DNA from blood samples was available for 304 stomach cancer patients and 427 control subjects. We observed a 1.48-fold increased risk for stomach cancer (95% confidence interval 0.97-2.25) in patients with the GSTT1 null genotype but no evidence of increased risk associated with the GSTM1, GSTM3 or GSTP1 genotypes. Furthermore, the stomach cancer risk associated with the GSTT1 null genotype varied by age at diagnosis, with odds ratios of 3.85, 1.91, 1.78 and 0.59 for those diagnosed at ages less than 50, 50-59, 60-69 and 70 years or older, respectively (P trend = 0.01). This was due to a shift in the GSTT1 genotype distribution across age groups among stomach cancer patients only. These results suggest that the GSTT1 null genotype may be associated with increased risk of stomach cancer.

Isolation and developmental expression of two nuclear receptors, MHR4 and betaFTZ-F1, in the tobacco hornworm, Manduca sexta

The cDNAs for two members of the nuclear receptor superfamily were isolated from the tobacco hornworm, Manduca sexta. The deduced amino acid sequence of MHR4 shows 93-95% identity in the DNA-binding domain and the first portion of the hinge (D) region with the germ cell nuclear factor (GCNF)-related factors (GRFs) of the silkworm, Bombyx mori, and the mealworm, Tenebrio molitor, and with a genomic sequence from the fruit fly, Drosophila melanogaster. Northern blot hybridization showed that a 7.5 kb MHR4 mRNA appeared in Manduca abdominal epidermis just as the ecdysteroid titer began to decline during the larval molt, disappeared about 12 h later, then transiently reappeared shortly before larval ecdysis. During the pupal and adult molts, a similar pattern of expression was seen (the very end of the adult molt was not studied). At peak times of expression in the epidermis, MHR4 mRNA was also present in fat body and the central nervous system (CNS). The deduced amino acid sequence of Manduca FTZ-F1 is 100% and 96% identical to that of B. mori and Drosophila betaFTZ-F1, respectively, in the DNA-binding domain and the adjacent hinge region including the FTZ-F1 box. Northern blot analysis showed that the >9.5 kb betaFTZ-F1 mRNA appeared in Manduca epidermis during the decline of the ecdysteroid titer in the larval, pupal and adult molts as the first peak of MHR4 mRNA declined, then it disappeared in the larval and pupal molts before the second peak of MHR4 appeared. betaFTZ-F1 mRNA was also found in fat body and the CNS at the time of peak expression in the epidermis during the larval and pupal molts. Both MHR4 and betaFTZ-F1 mRNAs were found in the testis during the onset of spermatogenesis in the prepupal period.

p53 gene expression in relation to indoor exposure to unvented coal smoke in Xuan Wei, China

Lung cancer mortality rates in Xuan Wei County, which are among the highest in China, have previously been associated with exposure to indoor emissions from burning smoky coal. To determine if this association is stronger among lung cancer patients with abnormal expression of p53, we performed a population-based case-control study. Ninety-seven newly diagnosed lung cancer patients and 97 controls, individually matched by age, sex, and home fuel type, were enrolled. We used immunocytochemical methods to assess p53 protein accumulation in exfoliated tumor cells isolated from sputum samples. As expected, the amount of lifetime smoky coal use was associated with an overall increase in lung cancer risk. Compared with subjects who used less than 130 tons of smoky coal during their lifetime, the odds ratios (OR) for lung cancer were 1.48 (95% confidence interval [CI], 0.73 to 3.02) for subjects exposed to 130 to 240 tons, and 3.21 (95% CI, 1.23 to 9.03) for subjects who used more than 240 tons of smoky coal (P for trend 0.01). The effect was due almost exclusively to the pattern in women, almost all of whom were nonsmokers. Further, among highly exposed women, the association was substantially larger and achieved statistical significance only among patients with sputum samples that were positive for p53 overexpression (OR, 18.72; 95% CI, 1.77 to 383.38 vs OR, 4.80; 95% CI, 0.66 to 43.87 for p53-negative cases). This study suggests that exposure to the combustion products of smoky coal in Xuan Wei is more strongly associated with women who have lung cancer accompanied by p53 protein overexpression in exfoliated tumor cells.

Indoor coal combustion emissions, GSTM1 and GSTT1 genotypes, and lung cancer risk: a case-control study in Xuan Wei, China

The lung cancer mortality rate in Xuan Wei County, China is among the highest in the country and has been associated with exposure to indoor smoky coal emissions that contain high levels of polycyclic aromatic hydrocarbons. This risk may be modified by variation in metabolism genes, including GSTM1, which encodes an enzyme known to detoxify polycyclic aromatic hydrocarbons. To investigate the relationship between GST genotypes and lung cancer risk in Xuan Wei County, we analyzed GSTM1 and GSTT1 genotypes in a population-based case-control study. A total of 122 lung cancer patients and 122 controls, individually matched by age, sex, and home fuel type, were studied. Compared to subjects who used less than 130 tons of smoky coal during their lifetime, heavier users (> or =130 tons) had a 2.4-fold (95% confidence interval, 1.3-4.4) increased risk of lung cancer. The GSTM1-null genotype was associated with a 2.3-fold (95% confidence interval, 1.3-4.2) increased risk of lung cancer. Furthermore, there was some evidence that smoky coal use was more strongly associated with lung cancer risk among GSTM1-null versus GSTM1-positive individuals. In contrast, the GSTT1 genotype was not significantly associated with lung cancer risk. Our data suggest that the GSTM1-null genotype may enhance susceptibility to air pollution from indoor coal combustion emissions.