Objectives: To investigate the association between survivin gene promoter -31 C/G polymorphism and urothelial carcinoma (UC) risk in a Taiwanese population. Methods: A total of 190 patients with pathologically confirmed UC and 210 unrelated controls without cancer were recruited at Chiayi Christian Hospital from August 2002 to May 2007. The -31 C/G polymorphism in the survivin gene promoter was determined using polymerase chain reaction-restriction fragment length polymorphism analysis. Results: Compared with study subjects carrying the G/G genotype, significantly increased UC risks were found for individuals carrying the C/G genotype (odds ratio 2.8; 95% confidence interval [CI] 1.7-4.6) and those with the C/C genotype (odds ratio 4.0; 95% CI 2.3-7.2). Those carrying the C/C or C/G genotype had a significantly increased UC risk of 3.2 (95% CI 1.9-5.2) compared with those with the G/G genotype. Among heavy smokers (≥30 pack-years), we found a significantly increased UC risk of 3.8 (95% CI 1.3-11.3) for individuals with the C/C or C/G genotype compared with those with the G/G genotype. Furthermore, patients with UC carrying the C/C genotype had a significantly greater prevalence of muscle-invasive (Stage T2-T4), high-grade (G3), or invasive, high-grade tumor compared with those carrying the G/G genotype. Conclusions: These findings suggest that the -31 C/G polymorphism of the survivin gene promoter is associated with both the clinical tumor stage and the pathologic tumor grade and might be involved in the development of UC.
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