Do smoking and polymorphisms in xenobiotic metabolizing enzymes affect the histological stage and grade of bladder tumors

Cigarette smoking and genetic susceptibility are the two factors most closely associated with bladder cancer development. This study sought to determine the effect of smoking and genetic polymorphisms in xenobiotic metabolizing enzymes on the histological stage and grade of bladder tumors in Tunisian patients. A total of 97 patients with urothelial cell carcinomas were examined with respect to smoking status, NAT2 (N-acetyltransferase 2), GSTM1 and GSTT1 (glutathione S-transferase Mu 1 and teta 1) genotypes distribution. Our data have reported that tobacco; NAT2, GSTM1 and GSTT1 genotypes were not associated with bladder tumor stage. When we studied the superficial bladder tumor group, we have shown that in smokers tobacco was associated with the development of low-grade tumors. Conversely, non-smoker patients carrying altered NAT2 genotypes were with a 3.67-fold increased risk of developing superficial high-grade tumors (P = 0.02; RR = 3.67; 95% CI: [1.40-9.62]).