1986 Volume 77 Issue 6 Pages 977-987
The analysis of the blood group isoantigen (BGA) in bladder tumor is valuable for the prediction of malignant potential. We have employed PAP method to detect the loss of BGA and made classification of staining patterns of BGA. In order to obtain clinically valuable and useful criteria for the loss of BGA, 129 bladder tumors including 86 superficial tumors were examined. Carcinoembryonic antigen (CEA) and fibronectin (FN) were also detected in the same tissue by PAP method and clinical usefluness was invesitigated in the correlation with the loss of BGA.
BGA staining pattern was classified into 5 types as follows,
Type I: Stained homogeneously as intensely as normal urothelium.
Type II: Stained homogeneously but less intensely than normal urothelium.
Type III-a: Stained non-homogeneously with negative area. (less than 50%)
Type III-b: Stained non-homogeneously with negative area. (more than 50%)
Type IV: Stained negatively with no positive area.
No correlation was found between histological grade and BGA staining pattern. CEA was detected in 13 of all 129 tumors (10.1%) and in 10 of 86 superficial tumors (11.6%). CEA was detected at a high incidence in grade 3 bladder tumors. Negative rate of tissue FN was 26.6% in all cases and was correlated with histological stage.
Analysis of the loss of BGA is the most valuable for the prediction of malignant potential of bladder tumor especially in low stage, because out of 86 cases of low stage bladder tumor all 10 cases with subsequent invasive recurrence belonged to type III-b or type IV. In conclusion, it was possible to propose new criteria for the loss of BGA i. e., type I & type II: positive, type III-a: borderline, type III-b & type IV: negative.
