Association of N-acetyltransferase 1 polymorphism and bladder cancer risk: an updated meta-analysis and trial sequential analysis



Individual studies of the association between N-acetyltransferase 1 (NAT1)*10 allele and bladder cancer susceptibility have shown inconclusive results. To derive a more precise estimation of any such relationship, we performed this systemic review and updated meta-analysis based on 17 publications.


A total of 17 studies were investigated with 4,322 bladder cancer cases and 4,944 controls. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. Subgroup analyses were conducted based on ethnicity, sex, source of controls and detecting methods. Then trial sequential analysis was performed to evaluate whether the evidence of the results was sufficient and reduce the risk of type I error.


There was no association between NAT1*10 allele and bladder cancer risk in a random-effects model (OR = 0.96, 95% CI, 0.84-1.10) or in a fixed-effects model (OR = 0.95, 95% CI, 0.87-1.03). In addition, no significantly increased risk of bladder cancer was found in any other subgroup analysis. Then, trial sequential analyses demonstrated that the results of our study need to be further verified.


Despite its limitations, the results of the present meta-analysis suggested that there was no association between NAT1*10 allele and bladder cancer risk. More importantly, our findings need to be further validated regarding whether being without the NAT1*10 allele could in the future be shown to be a potential marker for the risk of bladder cancer.

Int J Biol Markers 2017; 32(3): e297 - e304




Zicheng Xu, Xiao Li, Zhiqiang Qin, Jianxin Xue, Jingyuan Wang, Zhentao Liu, Hongzhou Cai, Bin Yu, Ting Xu, Qin Zou

Article History


Financial support: No grants or funding have been received for this study.
Conflict of interest: We declare that we have no conflict of interest.

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  •  Department of Urologic Surgery, The Affiliated Cancer Hospital of Jiangsu Province of Nanjing Medical University, Nanjing - PR China
  •  Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing - PR China
  •  Department of Urology, The Second Hospital of Nanjing, Affiliated to the Medical School of Southeast University, Nanjing - PR China
  •  Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing - PR China
  • Zicheng Xu, Xiao Li and Zhiqiang Qin contributed equally to this work.

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