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Differential Association of the Codon 72 p53 and GSTM1 Polymorphisms on Histological Subtype of Non-Small Cell Lung Carcinoma¹

Departments of Environmental Health, Occupational Health Program [G. L., D. P. M., W. Z., R. F., L-L. X., L. S., D. C. C.] and Biostatistics [S. W. T.], Harvard School of Public Health, Boston, Massachusetts 02115; and the Division of Hematology-Oncology [G. L., T. J. L.], Pulmonary and Critical Care Units [D. C. C.], Department of Medicine, and Thoracic Surgery Unit, Department of Surgery [J. C. W.], Massachusetts General Hospital, Boston, Massachusetts 02114

Traditionally, non-small cell lung cancer (NSCLC) has been evaluated as a unique entity in genotyping studies. However, recent biological data suggest that different NSCLC subtypes, specifically adenocarcinomas (AC) and squamous cell carcinomas (SCC), differentially alter cancer behavior. Several studies have associated a p53 polymorphism at codon 72 with NSCLC susceptibility. This study investigated whether different p53 genotypes altered the overall risk of developing AC versus SCC. Polymorphisms in metabolizing enzymes, together with prolonged exposure to tobacco carcinogens, can result in accumulation of DNA damage; these effects may potentiate the effects of subtle differences in p53 function. Thus, interactions between polymorphisms of p53 and either GSTM1 or GSTT1 were also evaluated. We analyzed 1168 incident lung cancer cases and 1256 control subjects using multiple logistic regression. Histological data were available for 1144 cases (98%): 585 with AC, 284 with SCC, and 275 with other histological subtypes (large cell, small cell, mixed, and other). An increase in the NSCLC risk posed by the p53 Pro allele (versus Arg/Arg) was seen in AC compared with controls [adjusted odds ratio (OR), 1.36; 95% confidence interval (CI), 1.1–1.7] but not in SCC (adjusted OR, 1.04; 95% CI, 0.8–1.4). Among AC and SCC cancer patients, individuals with the GSTM1-null genotype had an OR of 1.80 (95% CI, 1.1–2.8; case-only analysis) of having AC versus SCC if they also carried a p53 Pro allele. We conclude that different genotype combinations of p53 and GSTM1 increase the risk of developing specific histological subtypes of NSCLC.

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