Glutathione S-transferase M1 and T1 Polymorphisms, Cigarette Smoking and HPV Infection in Precancerous and Cancerous Lesions of the Uterine Cervix

Glutathione S-transferases (GSTs) play an important role in detoxification of carcinogenic electrophiles.The null genotypes in GSTM1 and GSTT1 have been implicated in carcinogenesis. Present study was planned toevaluate the influence of genetic polymorphisms of GSTM1 and GSTT1 gene loci in cervical carcinogenesis. Thestudy was conducted in Lok Nayak hospital, New Delhi. DNA from clinical scrapes of 482 women with minorgynaecologic complaints attending Gynaecology OPD and tumor biopsies of 135 cervical cancer cases attendingthe cancer clinic was extracted. HPV DNA was detected by standard polymerase chain reaction (PCR) usingL1 consensus primer pair. Polymorphisms of GSTM1 and GSTT1 were analysed by multiplex PCR procedures.Differences in proportions were tested using Pearson’s Chi-square test with Odds ratio (OR) and 95% confidenceinterval (CI). The risk of cervical cancer was almost three times in women with GSTM1 homozygous null genotype(OR-2.62, 95%CI, 1.77-3.88; p<0.0001). No association of GSTM1 or GSTT1 homozygous null genotypes wasobserved in women with normal, precancerous and cervical cancerous lesions among ≤35 or >35 years of agegroups. Smokers with null GSTT1 genotype had a higher risk of cervical cancer as compared to non-smokers(OR-3.01, 95% CI, 1.10-8.23; p=0.03). The results further showed that a significant increased risk of cervicalcancer was observed in HPV positive smoker women with GSTT1 (OR-4.36, 95% CI, 1.27-15.03; p=0.02) andGSTM1T1 (OR-3.87, 95% CI, 1.05-14.23; p=0.04) homozygous null genotypes as compared to HPV positive nonsmokers. The results demonstrate that the GST null genotypes were alone not associated with the developmentof cervical cancer, but interacted with smoking and HPV to exert effects in our Delhi population.