Recently the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, immature vascular disease, neural tube defect, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancer, and particularly gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metaboism, and influences DNA synthesis and DNA methylation. Generally, folate deficiency is associated with gastrointestinal neoplasms. The amino-acid- changing and enzyme-activity-reducing nucleotide polymorphism (766C→T/ Ala222Val) has been described in the MTHFR polymorphism and leads to low enzyme activity that may reduce the capacity of DNA methylation and possibly uracil mis-incorporation into DNA. These processes may be critical in the oncogenic transformation of human cells, especially in colorectal carcinomas. We investigated the relationship between the MTHFR polymorphism in gastric cancer and the tumor site, the smoking history, and the alcoholic history.

Ninety-six (96) individuals with gastric cancer and 287 healthy persons were analyzed. Blood sampling was performed, PCR-RFLP was analyzed, and MTHFR polymorphism genotypes of C/C, C/T, and T/T were obtained and analyzed statistically for their correlation.

In the gastric cancer group there were 69 (72%) males and 27 (28%) females. There were also 58 cases (60%) involving the gastric lower body, 20 cases (21%) the gastric mid-body, and 18 cases (19%) the gastric upper body. In the control group there were 169 (59%) males and 118 (41%) females. Among the gastric cancer, 56 (61%) smoking patients, 40 (39%) non-smoking patients, 45(47%) alcoholic patients, 51 (53%) non-alcoholic patients. In the gastric cancer group, MTHER polymorphisms were C/C in 18 (19%) cases, C/T in 59 (61%) cases, T/T in 19 (20%) cases. In the control group polymorphisms were C/C 116 (40%) cases, C/T 103 (36%) cases, and T/T 68 (24%) cases (P=0.045). In cases of lower gastric body cancer, polymorphisms were C/C in 16 (24%) C/C in 16 (24%) cases and C/T or T/T in 42 (72%) cases. In cases of upper and mid-body cancer, polymorphisms were C/C in 2 (5%) cases and C/T or T/T 36 (95%) cases (P=0.006). In the non-smoking patient group, polymorphisms were C/C in 5 (12%) cases and C/T or T/T in 35 (88%) cases. In the smoking patient group, C/C in 13 (23%) cases and C/T or T/T in 43 (77%) cases (P=0.189). In the non-alcoholic patient group, polymorphisms were C/C in 6 (12%) cases and C/T or T/T in 45 (88%) cases. In the alcoholic patient group, polymorphisms were C/C in 12 (26%) cases and C/T or T/T in 33 (74%) cases (P=0.063).

MTHFR polymorphisms are associated with gastric cancer and tumor site, but not with smoking and alcohol drinking.