title: Renal cell carcinoma Fuhrman grade and histological subtype correlate with complete polymorphic deletion of glutathione S-transferase M1 gene.
abstract: OBJECTIVE
  We outlined the putative significance of GST in renal cell carcinoma biology by investigating the influence of its deletion polymorphisms on renal cell carcinoma progression.
  
  
  METHODS
  Genomic DNA was purified from peripheral blood leukocytes. GSTM1 and GSTT1 genes were polymerase chain reaction amplified and gene fragments were separated by agarose gel electrophoresis. Intact GSTM1 and GSTT1 alleles were identified by the presence of 230 and 480 bp fragments, respectively. Genotypes were associated with clinicopathological variables and survival.
  
  
  RESULTS
  Of 147 patients with renal cell carcinoma 80 (54%) had the GSTM1 null and 27 (18%) had the GSTT1 null genotype. The GST genotype distribution did not differ significantly from that in 112 controls without renal cell carcinoma. However, the GSTM1 null genotype was associated with 60% lower odds of the papillary subtype (OR 0.40, 95% CI 0.18 to 0.92, p = 0.032), lower Fuhrman grade (chi-square 9.77, p = 0.008) and a lower risk of metastatic disease in patients with the clear cell subtype (chi-square 4.48, p = 0.034). Of patients with the clear cell subtype those with the GSTM1 null genotype had improved cancer specific survival (p = 0.0412). GSTT1 did not correlate with any pathological variable except age at renal cell carcinoma onset since patients with renal cell carcinoma and the GSTT1 null genotype were significantly younger than their counterparts (mean +/- SD age 58.5 +/- 14.2 vs 65.4 +/- 12.8 years, p = 0.016).
  
  
  CONCLUSIONS
  GSTM1 deletion polymorphism impacts renal cell carcinoma histological subtype, Fuhrman grade and metastatic behavior while GSTT1 deletion leads to renal cell carcinoma onset at a younger age. In patients with clear cell renal cell carcinoma the GSTM1 null genotype may be associated with better prognosis.
authors.affiliation: Ludwig Boltzmann Cluster of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Michela
authors.initials: M
authors.lastname: De Martino
authors.forename: Tobias
authors.initials: T
authors.lastname: Klatte
authors.forename: Georg
authors.initials: G
authors.lastname: Schatzl
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.forename: Matthias
authors.initials: M
authors.lastname: Waldert
authors.forename: Andrea
authors.initials: A
authors.lastname: Haitel
authors.forename: Igor
authors.initials: I
authors.lastname: Stancik
authors.forename: Gero
authors.initials: G
authors.lastname: Kramer
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
mesh_terms: D002292:Carcinoma, Renal Cell / Q000145:classification* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D017353:Gene Deletion; D005982:Glutathione Transferase / Q000235:genetics*; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic
chemical_list: D005982:Glutathione Transferase; C495790:glutathione transferase T1-1, human