| Summary: | 碩士 === 國立臺灣大學 === 流行病學研究所 === 85 === As the population in Taiwan is getting older and older,
the study of urothelial carcinoma ( including bladder, renal
pelvis and ureter cancer ) which occurs mostly in elderly people
becomes more and more important. In addition to the exploration
of possible environmental risk factors, recent studies of this
cancer have focused on the interaction between environmental and
genetic factors.This study aimed to investigate the modification
effect of genetic susceptibility on the association between
environmental exposure and risk of urothelial carcinoma.
A total of 128 urothelial carcinoma patients and 264 controls
were serially recruited from National Taiwan University
Hospital. Based on their arsenic exposure , all subjects were
divided into three groups : * ever-lived in black foot disease-
endemic area*, * ever-lived in arseniasis-endemic area of
southwestern Taiwan* and * other areas*. Peripheral blood
lymphocytes were collected from each subject and genotyped for
N-acetyltransferase 1 and 2 ( NAT1 and NAT2 ) by DNA sequencing
and PCR-RFLP methods, respectively. Cigarette smoking,
passive cigarette smoking,intake of fermented beans, salted food
,and smoked food , and urinary stone were found to be risk
factors of urothelial carcinoma. There was a dose-response
relationship between cigarette smoking and risk of urothelial
carcinoma. The proportion of NAT2 rapid genotype was higher in
urothelial cancer patients who ever lived in the arseniasis-
endemic area rather than those lived in other areas, but the
result was not statistically significant. Among subjects with
NAT1 rapid or NAT2 slow genotype, cigarette smoking was
associated with an increased risk of urothelial carcinoma (
OR=2.9, 95% confidence interval = 1.4 - 5.9 ). In the
multivariate regression analysis,intake of fermented beans and
smoked food or urinary stone were not significantly associated
with urothelial carcinoma. cigarette smoking was the only
significant risk factor of urothelial carcinoma. NAT1 and NAT2
genotypes modified the effect of cigarette smoking on the
development of urothelial carcinoma.
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