Relationships among cigarette smoking, urinary biomarkers, and urothelial carcinoma risk: a case-control study
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RESEARCH ARTICLE
Relationships among cigarette smoking, urinary biomarkers, and urothelial carcinoma risk: a case-control study Chi-Jung Chung 1,2 & Hui-Tsung Hsu 1 & Chao-Hsiang Chang 3 & Sheng-Wei Li 4 & Chiu-Shong Liu 5 & Mu-Chi Chung 6 & Guo-Wei Wu 1 & Wei-Ting Jung 7 & Yen-Jung Kuo 7 & Hui-Ling Lee 7 Received: 28 April 2020 / Accepted: 20 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Cigarette smoke is a known risk factor for urothelial carcinoma (UC). However, there is limited information about the distributions and effects of volatile organic compounds (VOCs) on smoking-related UC risk. With this hospital-based case-control study, we explored the associations between urinary levels of cotinine and VOC metabolites (acrylamide, 1,3-butadiene, and benzene) and the risk of UC. Urological examinations and pathological verifications were used to confirm the diagnoses of UC. All study participants provided smoking-related information via questionnaires and face-to-face interviews; they also provided urine samples for the measurement of VOC metabolites, cotinine, and 8-hydroxydeoxyguanosine (8-OHdG), which was used as an indicator of oxidative stress. We applied multiple logistic regression analysis to estimate the risk of UC, and we found that levels of urinary cotinine and 8-OHdG were higher in the UC group than in the control group. Furthermore, urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-Lcysteine (AAMA), N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine-3, trans,trans-muconic acid (t,t-MA), and S-phenylmercapturic acid (SPMA), increased with increasing levels of urinary cotinine. After adjusting for potential risk factors, dose–response relationships were observed between UC risk and urinary levels of AAMA, t,t-MA, SPMA, and 8-OHdG. Participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG had risks of UC that were 3.5- to 6-fold higher than those of participants with lower levels. Future, large-scale investigations of the risks of UC should be explored, and repeated measurement of VOC metabolites should be assessed. Keywords Volatile organic compound . Benzenes . Urothelial carcinoma . 8-hydroxydeoxyguanosine . Cotinine . Butadiene . Acrylamide
Abbreviations VOCs Volatile organic compounds UC Urothelial carcinoma
AAMA GAMA
N-acetyl-S-(2-carbamoylethyl) -L-cysteine N-acetyl-S-(2-carbamoyl-2hydroxyethyl)-L-cysteine
Responsible editor: Lotfi Aleya * Chi-Jung Chung [email protected] * Hui-Ling Lee [email protected] 1
Department of Public Health, China Medical University, No. 91 Hsueh-Shih Road, Taichung 40402, Taiwan
2
Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
3
Department of Urology, China Medical University Hospital, Taichung, Taiwan
4
Department of Urology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
5
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
6
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