ISOANTIGENS ABH IN BLADDER TUMORS AS AN INDICATOR OF MALIGNANT POTENTIAL

IV. Correlation with Thomsen-Friedenreich Antigen and CEA

Abstract

We studied prognostic significance of blood group ABH (BGA) and Thomen-Friedenreich antigen (T-antigen) and carcinoembryonic antigen (CEA) in 86 patients, who had initially low stage transitional cell carcinoma of the bladder and had been followed for 3 to 8 years. BGA and CEA were detected by the peroxidase-antiperoxidase method (PAP), and T-antigen by the T-specific lectin (Peanut agglutinin) immuno-peroxidase method using paraffin section.
Staining patterns of BGA by PAP were classified into 5 types as follows:
Type I: Stained homogeneously and as intensely as normal urothelium.
Type II: Stained homogeneously but less intensely than normal urothelium.
Type IIIa: Stained non-homogeneously with negative area (less than 50%).
Type IIIb: 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 patterns. CEA was detected in 10 of 86 (11.6%) superficial tumors and was detected at a higher incidence in grade 3 bladder tumors.
Recurrence rate of the cases with type IIIb, V is higher than that with other types. Moreover, all cases (10 cases) with invasive recurrence belonged to type IIIb, IV. T-antigen expression was also significantly related to subsequent recurrence with invasion. CEA was less effective than BGA in predicting clinical course. Of these markers, BGA is the most reliable indicator of biological behaviors of future recurrent tumors as a single marker system. In combination study, any combination did not enhance the accurracy compared with BGA alone. Consequently, cases with BGA expression of type IIIb or IV and T-antigen expression of cryptic T-antigen negative have been proved to be high risk groups for invasive recurrence.