Skip to main content
Log in

Quantitative assessment of the effect of glutathione S-transferase genes GSTM1 and GSTT1 on hepatocellular carcinoma risk

  • Research Article
  • Published:
Tumor Biology

Abstract

Hepatocellular carcinoma (HCC) is one of the most serious health problems worldwide. As in many other diseases, environment and genetic factors are believed to be involved in the pathogenesis of HCC. Numerous epidemiologic investigations including case–control and cohort studies have suggested the association of glutathione S-transferase (GST) genetic polymorphisms and HCC risk. However, some studies have produced conflicting results. Therefore, we performed an updated meta-analysis to clarify this inconsistency and to establish a comprehensive picture of the association of the polymorphisms of GSTM1 and GSTT1 with HCC susceptibility. We searched PubMed, Embase, ISI Web of Science, and CNKI databases to identify eligible studies meeting the inclusion criteria up to August 30, 2013. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of association. Finally, there were a total of 33 studies with 4,232 cases and 6,601 controls included in this meta-analysis. In the pooled analysis, significantly increased HCC risks were found for null genotype of GSTM1 (OR = 1.31, 95 % CI = 1.07–1.61, P = 0.010, P heterogeneity < 10−5) and GSTT1 (OR = 1.47, 95 % CI = 1.25–1.74, P < 10−5, P heterogeneity < 10−5). Potential sources of heterogeneity were explored by subgroup analysis based on ethnicity, sample size, and source of control. Significant results were found among East Asians and Indians when stratified by ethnicity, while no evidence of significant associations was observed among Caucasian and African populations. In the gene–gene interaction analysis, a statistically significant increased risk for HCC was detected for individuals with combined deletion mutations in both genes compared to those with wild genotypes (OR = 1.88, 95 % CI = 1.41–2.50, P < 10−4, P heterogeneity = 0.004). The present meta-analysis demonstrated that the GSTM1 and GSTT1 null genotype may be associated with an increased risk of HCC and that individuals having the combination of both defective GST genotypes may be more susceptible to developing HCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aghemo A, Colombo M. Hepatocellular carcinoma in chronic hepatitis C: from bench to bedside. Semin Immunopathol. 2013;35(1):111–20.

    Article  PubMed  Google Scholar 

  2. Cabibbo G, Maida M, Genco C, Antonucci M, Camma C. Causes of and prevention strategies for hepatocellular carcinoma. Semin Oncol. 2012;39(4):374–83.

    Article  PubMed  Google Scholar 

  3. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.

    Article  PubMed  Google Scholar 

  4. Yu MC, Tong MJ, Govindarajan S, Henderson BE. Nonviral risk factors for hepatocellular carcinoma in a low-risk population, the non-Asians of Los Angeles County. California. J Natl Cancer Inst. 1991;83(24):1820–6.

    Article  CAS  PubMed  Google Scholar 

  5. Morgan TR, Mandayam S, Jamal MM. Alcohol and hepatocellular carcinoma. Gastroenterology. 2004;127(5 Suppl 1):S87–96.

    Article  CAS  PubMed  Google Scholar 

  6. Roberts SK, Kemp W. Hepatocellular carcinoma in an Australian tertiary referral hospital 1975–2002: change in epidemiology and clinical presentation. J Gastroenterol Hepatol. 2007;22(2):191–6.

    Article  PubMed  Google Scholar 

  7. Atkinson HJ, Babbitt PC. Glutathione transferases are structural and functional outliers in the thioredoxin fold. Biochemistry. 2009;48(46):11108–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hayes JD, Flanagan JU, Jowsey IR. Glutathione transferases. Annu Rev Pharmacol Toxicol. 2005;45:51–88.

    Article  CAS  PubMed  Google Scholar 

  9. Udomsinprasert R, Pongjaroenkit S, Wongsantichon J, Oakley AJ, Prapanthadara LA, Wilce MC, et al. Identification, characterization and structure of a new delta class glutathione transferase isoenzyme. Biochem J. 2005;388(Pt 3):763–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. McIlwain CC, Townsend DM, Tew KD. Glutathione S-transferase polymorphisms: cancer incidence and therapy. Oncogene. 2006;25(11):1639–48.

    Article  CAS  PubMed  Google Scholar 

  11. Hayes JD, Strange RC. Glutathione S-transferase polymorphisms and their biological consequences. Pharmacology. 2000;61(3):154–66.

    Article  CAS  PubMed  Google Scholar 

  12. Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10(1):101–29.

    Article  Google Scholar 

  13. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.

    Article  CAS  PubMed  Google Scholar 

  14. Woolf B. On estimating the relation between blood group and disease. Ann Hum Genet. 1955;19(4):251–3.

    Article  CAS  PubMed  Google Scholar 

  15. Asim M, Khan LA, Husain SA, Husain S, Sarma MP, Ahmad I, et al. Genetic polymorphism of glutathione S transferases M1 and T1 in Indian patients with hepatocellular carcinoma. Dis Markers. 2010;28(6):369–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Borentain P, Gerolami V, Ananian P, Garcia S, Noundou A, Botta-Fridlund D, et al. DNA-repair and carcinogen-metabolising enzymes genetic polymorphisms as an independent risk factor for hepatocellular carcinoma in Caucasian liver-transplanted patients. Eur J Cancer. 2007;43(17):2479–86.

    Article  CAS  PubMed  Google Scholar 

  17. Chen SY, Wang LY, Lunn RM, Tsai WY, Lee PH, Lee CS, et al. Polycyclic aromatic hydrocarbon-DNA adducts in liver tissues of hepatocellular carcinoma patients and controls. Int J Cancer. 2002;99(1):14–21.

    Article  CAS  PubMed  Google Scholar 

  18. Covolo L, Gelatti U, Talamini R, Garte S, Trevisi P, Franceschi S, et al. Alcohol dehydrogenase 3, glutathione S-transferase M1 and T1 polymorphisms, alcohol consumption and hepatocellular carcinoma (Italy). Cancer Causes Control. 2005;16(7):831–8.

    Article  PubMed  Google Scholar 

  19. Deng ZL, Wei YP, Ma Y. Polymorphism of glutathione S-transferase mu 1 and theta 1 genes and hepatocellular carcinoma in southern Guangxi. China. World J Gastroenterol. 2005;11(2):272–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Dong C, Yu S, Chen G, Zhao D, Fu Y. Polymorphisms of GSTT1 and M1 genotypes and their effects on elevated aflatoxin exposure and increased risk of hepatocellular carcinoma. Zhong Liu Fang Zhi Yan Jiu. 1997;24(6):327–9.

    Google Scholar 

  21. Guo H, Bian J, Jiang F, Wang Q, Zhang Z, Fan W, et al. The null genotype of GSTM1 and GSTT1 and the genetic susceptibility of primary liver cancer in Luoyang China. Tumor. 2005;25(1):58–61.

    CAS  Google Scholar 

  22. He S, Gu Y, Liao Z. Glutathione S-transferase M1 genetic polymorphism, alcohol consumption, cigarette smoking and hepatocellular carcinoma. J Guangxi Med Univ. 2008;25(4):567–8.

    CAS  Google Scholar 

  23. Huang T, Liang F, Shi J, Liang R, Wei Z, Tang B. A case–control study for detecting risk factors of primary liver cancer in Fusui. Guangxi. J Guangxi Med Univ. 2000;17(5):758–60.

    Google Scholar 

  24. Imaizumi T, Higaki Y, Hara M, Sakamoto T, Horita M, Mizuta T, et al. Interaction between cytochrome P450 1A2 genetic polymorphism and cigarette smoking on the risk of hepatocellular carcinoma in a Japanese population. Carcinogenesis. 2009;30(10):1729–34.

    Article  CAS  PubMed  Google Scholar 

  25. Kiran M, Chawla YK, Kaur J. Glutathione-S-transferase and microsomal epoxide hydrolase polymorphism and viral-related hepatocellular carcinoma risk in India. DNA Cell Biol. 2008;27(12):687–94.

    Article  CAS  PubMed  Google Scholar 

  26. Kirk GD, Turner PC, Gong Y, Lesi OA, Mendy M, Goedert JJ, et al. Hepatocellular carcinoma and polymorphisms in carcinogen-metabolizing and DNA repair enzymes in a population with aflatoxin exposure and hepatitis B virus endemicity. Cancer Epidemiol Biomarkers Prev. 2005;14(2):373–9.

    Article  CAS  PubMed  Google Scholar 

  27. Ladero JM, Martinez C, Garcia-Martin E, Ropero P, Briceno O, Villegas A, et al. Glutathione S-transferase M1 and T1 genetic polymorphisms are not related to the risk of hepatocellular carcinoma: a study in the Spanish population. Eur J Cancer. 2006;42(1):73–7.

    Article  CAS  PubMed  Google Scholar 

  28. Li S, Wu J, Ding J, Gao C, Cao H, Zhou X. Impact of genetic polymorphisms of glutathione S-transferaseT1, M1 on the risk of primary hepatocellular carcinoma in alcohol drinkers. Pract J Cancer. 2004;19(3):229–34.

    CAS  Google Scholar 

  29. Liu C, Bian J, Jiang F, Shen F. Genetic polymorphisms of glutathione S-transferases M1, T1, P1 on susceptibility hepatocellular carcinoma. China Public Health. 2002;18(8):935–8.

    CAS  Google Scholar 

  30. Liu Z, Wei Y, Ma Y, Deng Z. Population with GSTT1 gene deletion and the relationship to hepatocellular carcinoma from Guangxi. J Guangxi Med Univ. 2003;20(2):161–3.

    CAS  Google Scholar 

  31. Long XD, Ma Y, Wei YP, Deng ZL. [Study on the detoxication gene gstM1-gstT1-null and susceptibility to aflatoxin B1 related hepatocellular carcinoma in Guangxi]. Zhonghua Liu Xing Bing Xue Za Zhi. 2005;26(10):777–81.

    PubMed  Google Scholar 

  32. Long XD, Ma Y, Wei YP, Deng ZL. The polymorphisms of GSTM1, GSTT1, HYL1*2, and XRCC1, and aflatoxin B1-related hepatocellular carcinoma in Guangxi population. China. Hepatol Res. 2006;36(1):48–55.

    Article  CAS  PubMed  Google Scholar 

  33. Abd El-Moneim E, Younis FA, Allam N, Gameel K, Osman M. Gene deletion of glutathione S-transferase M1 and T1 and risk factors of hepatocellular carcinoma in Egyptian patients. Egypt J Immunol. 2008;15(2):125–34.

    PubMed  Google Scholar 

  34. Ma D, Chen Y, Li Y, Zhao H, Xie X. Glutathione-S-transferase M1 and T1 polymorphisms (deficiency) and susceptibility to liver cancer in hepatitis B surface antigen positive (HBsAg positive) population. Guangxi Med J. 2005;27(5):656–8.

    CAS  Google Scholar 

  35. Munaka M, Kohshi K, Kawamoto T, Takasawa S, Nagata N, Itoh H, et al. Genetic polymorphisms of tobacco- and alcohol-related metabolizing enzymes and the risk of hepatocellular carcinoma. J Cancer Res Clin Oncol. 2003;129(6):355–60.

    Article  CAS  PubMed  Google Scholar 

  36. Sarma MP, Asim M, Medhi S, Bharathi T, Kar P. Hepatitis C virus related hepatocellular carcinoma: a case control study from India. J Med Virol. 2012;84(7):1009–17.

    Article  PubMed  Google Scholar 

  37. Sun CA, Wang LY, Chen CJ, Lu SN, You SL, Wang LW, et al. Genetic polymorphisms of glutathione S-transferases M1 and T1 associated with susceptibility to aflatoxin-related hepatocarcinogenesis among chronic hepatitis B carriers: a nested case–control study in Taiwan. Carcinogenesis. 2001;22(8):1289–94.

    Article  CAS  PubMed  Google Scholar 

  38. Tiemersma EW, Omer RE, Bunschoten A, Van’t Veer P, Kok FJ, Idris MO, et al. Role of genetic polymorphism of glutathione-S-transferase T1 and microsomal epoxide hydrolase in aflatoxin-associated hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2001;10(7):785–91.

    CAS  PubMed  Google Scholar 

  39. Wu H, Chen M, Liu P, Zhang R. Relationship between GSTM1 gene polymorphism and genetic susceptibility to primary hepatocellular carcinoma. Pract J Cancer. 2000;15(5):463–5.

    Google Scholar 

  40. Wu Y, Lu P, Wang J, Wang J, Wan S, Kensler T, et al. Correlation between the genetic polymorphism of EPHX and susceptibility to hepatocellular carcinoma. Tumor. 2003;23(4):287–90.

    CAS  Google Scholar 

  41. Xiao K, Li L, Peng M, Qin X, Peng T, Guo Y, et al. Gene polymorphisms of GSTM1 and GSTT1 in the clustering families of hepatocellular carcinoma. Chin J Oncol Prev Treat. 2011;3(4):287–91.

    Google Scholar 

  42. Yang Z, Xie Y, Kuang Z, Luo X, Zhang W, Leng C. Relationship between genetic polymorphisms of glutathione-S-transferase M1, T1 genes and susceptibility to hepatocellular carcinoma in population of Fusui District of Guangxi Zhuang Autonomous Region. Chin J Cancer Prev Treat. 2009;16(13):970–3.

    CAS  Google Scholar 

  43. Yu MW, Chiu YH, Chiang YC, Chen CH, Lee TH, Santella RM, et al. Plasma carotenoids, glutathione S-transferase M1 and T1 genetic polymorphisms, and risk of hepatocellular carcinoma: independent and interactive effects. Am J Epidemiol. 1999;149(7):621–9.

    Article  CAS  PubMed  Google Scholar 

  44. Yu MW, Yang SY, Pan IJ, Lin CL, Liu CJ, Liaw YF, et al. Polymorphisms in XRCC1 and glutathione S-transferase genes and hepatitis B-related hepatocellular carcinoma. J Natl Cancer Inst. 2003;95(19):1485–8.

    Article  CAS  PubMed  Google Scholar 

  45. Zhang Y, Deng C, Zhu Y. Study of genetic polymorphisms of xenobiotica metabolizing enzymes in hepatitis B virus-associated hepatic diseases. J Wenzhou Med Coll. 2005;35(6):464–8.

    Google Scholar 

  46. Zhu MH, Chen XH, Zhou LF. [Association of genetic polymorphisms in glutathione S-transferases M1 with hepatitis beta-related hepatocellular carcinoma]. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2005;34(2):126–30.

    CAS  PubMed  Google Scholar 

  47. Zhu W, Chen Q, Luo C, Chu X, Wu M. Relationship study between gene polymorphism of CYP1A1, GSTM1 and genetic susceptibility of primary hepatocellular carcinoma. China J Cancer Prev Treat. 2001;8(6):572–5.

    Google Scholar 

  48. Katoh T, Nagata N, Kuroda Y, Itoh H, Kawahara A, Kuroki N, et al. Glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) genetic polymorphism and susceptibility to gastric and colorectal adenocarcinoma. Carcinogenesis. 1996;17(9):1855–9.

    Article  CAS  PubMed  Google Scholar 

  49. Helzlsouer KJ, Selmin O, Huang HY, Strickland PT, Hoffman S, Alberg AJ, et al. Association between glutathione S-transferase M1, P1, and T1 genetic polymorphisms and development of breast cancer. J Natl Cancer Inst. 1998;90(7):512–8.

    Article  CAS  PubMed  Google Scholar 

  50. Zhong S, Wyllie AH, Barnes D, Wolf CR, Spurr NK. Relationship between the GSTM1 genetic polymorphism and susceptibility to bladder, breast and colon cancer. Carcinogenesis. 1993;14(9):1821–4.

    Article  CAS  PubMed  Google Scholar 

  51. Garte S, Gaspari L, Alexandrie AK, Ambrosone C, Autrup H, Autrup JL, et al. Metabolic gene polymorphism frequencies in control populations. Cancer Epidemiol Biomarkers Prev. 2001;10(12):1239–48.

    CAS  PubMed  Google Scholar 

  52. Wang J, Deng Y, Cheng J, Ding J, Tokudome S. GST genetic polymorphisms and lung adenocarcinoma susceptibility in a Chinese population. Cancer Lett. 2003;201(2):185–93.

    Article  CAS  PubMed  Google Scholar 

  53. London WT, Evans AA, McGlynn K, Buetow K, An P, Gao L, et al. Viral, host and environmental risk factors for hepatocellular carcinoma: a prospective study in Haimen City. China. Intervirol. 1995;38(3–4):155–61.

    Article  CAS  Google Scholar 

  54. Garner RC, Miller EC, Miller JA. Liver microsomal metabolism of aflatoxin B 1 to a reactive derivative toxic to Salmonella typhimurium TA 1530. Cancer Res. 1972;32(10):2058–66.

    CAS  PubMed  Google Scholar 

  55. McGlynn KA, Rosvold EA, Lustbader ED, Hu Y, Clapper ML, Zhou T, et al. Susceptibility to hepatocellular carcinoma is associated with genetic variation in the enzymatic detoxification of aflatoxin B1. Proc Natl Acad Sci U S A. 1995;92(6):2384–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Wild CP, Yin F, Turner PC, Chemin I, Chapot B, Mendy M, et al. Environmental and genetic determinants of aflatoxin-albumin adducts in the Gambia. Int J Cancer. 2000;86(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  57. Chen SY, Chen CJ, Tsai WY, Ahsan H, Liu TY, Lin JT, et al. Associations of plasma aflatoxin B1-albumin adduct level with plasma selenium level and genetic polymorphisms of glutathione S-transferase M1 and T1. Nutr Cancer. 2000;38(2):179–85.

    Article  CAS  PubMed  Google Scholar 

  58. Chen CJ, Yu MW, Liaw YF, Wang LW, Chiamprasert S, Matin F, et al. Chronic hepatitis B carriers with null genotypes of glutathione S-transferase M1 and T1 polymorphisms who are exposed to aflatoxin are at increased risk of hepatocellular carcinoma. Am J Hum Genet. 1996;59(1):128–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Kim SY, Choi JK, Cho YH, Chung EJ, Paek D, Chung HW. Chromosomal aberrations in workers exposed to low levels of benzene: association with genetic polymorphisms. Pharmacogenetics. 2004;14(7):453–63.

    Article  CAS  PubMed  Google Scholar 

  60. Xu X, Wiencke JK, Niu T, Wang M, Watanabe H, Kelsey KT, et al. Benzene exposure, glutathione S-transferase theta homozygous deletion, and sister chromatid exchanges. Am J Ind Med. 1998;33(2):157–63.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all the participants. This work was supported by Rising Star Project in Science and Technology of Shanghai (13QH1401000) and Shanghai Health Bureau scientific research found projects (no. 2008Y082).

Conflicts of interest

None

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Jia Fan or Ning Ren.

Additional information

Ying-Hao Shen and Si Chen contributed equally to this work.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 377 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shen, YH., Chen, S., Peng, YF. et al. Quantitative assessment of the effect of glutathione S-transferase genes GSTM1 and GSTT1 on hepatocellular carcinoma risk. Tumor Biol. 35, 4007–4015 (2014). https://doi.org/10.1007/s13277-013-1524-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-013-1524-2

Keywords

Navigation