Blood group antigens in normal and neoplastic urothelium Conference Paper


Authors: Sheinfeld, J.; Reuter, V. E.; Sarkis, A. S.; Cordon‐Cardo, C.
Title: Blood group antigens in normal and neoplastic urothelium
Conference Title: Chemoprevention of Premalignant and Early Malignant Lesions of the Bladder
Abstract: The ABO and Lewis blood group antigens are cell surface carbohydrate determinants formed by the sequential addition of saccharides to precursor backbone structures of membrane lipids and proteins. Suppression of normally active glycosyltransferases results in the absence of antigens that are normally expressed. ABH antigen deletion in malignant and premalignant urothelium has been extensively evaluated; it appears to correlate with significantly higher rates of tumor recurrence and disease progression. However, we have recently shown that the ABH blood group system is differentially expressed in the normal urothelium of secretors in contrast to nonsecretor individuals. The normal urothelium of nonsecretors does not express A, B or H determinants; therefore, deletion of ABH antigens can only be ascertained in secretor individuals. Although nonsecretors only comprise 22–24% of the population, this observation mandates a reevaluation of earlier studies. Deletion of A, B or H antigens is noted in carcinoma in situ (CIS), and in invasive and metastatic transitional cell carcinoma (TCC) of secretor individuals. Increased synthesis or activation of normally quiescent glycosyltransferases in bladder tumors can result in the expression of aberrant tumor‐associated blood group antigens. Immunohistochemical analysis has demonstrated that Lewis X (Lex) is not detected in normal adult urothelium except for occasional umbrella cells. However, papillomas, CIS and TCC expressed Lex in 84% of cases, regardless of grade, stage, blood type or secretor status of the individual. The presence of Lex positive cells in bladder lavage specimens enhanced the detection of urothelial tumor cells, correctly identifying bladder tumors in 253/293 (86%) cases compared to a 63% sensitivity for cytology alone. The specificity of Lex immunocytology was 87%; 57 of 65 control subjects were negative for the Lex antigen. Furthermore, the detection of the Lex antigen in exfoliated bladder cells is a useful marker for predicting bladder tumor relapse in high risk, disease‐free patients. All 17 Lex‐positive patients recurred with clinical evidence of disease between 2 and 33 months (mean 8.4 month), while only 8 of 39 Lex‐negative patients recurred; 31 patients remain NED (2–40 months, mean 16.2 months). © 1992 Wiley‐Liss, Inc. Copyright © 1992 Wiley‐Liss, Inc.
Keywords: controlled study; human tissue; review; conference paper; blood group abo system; abo blood-group system; bladder cancer; tumor marker; bladder tumor; urothelium; immunology; reference values; bladder neoplasms; tissue level; epithelium; alloantigen; isoantigens; lewis blood-group system; reference value; blood group lewis system; human; priority journal; blood group antigens; blood group antigen; lex
Journal Title Journal of Cellular Biochemistry
Volume: 50
Issue: Suppl. 16I
Conference Dates: 1992 Jul 29-Aug 2
Conference Location: Taos, NM
ISBN: 0730-2312
Publisher: John Wiley & Sons  
Date Published: 1992-01-01
Start Page: 50
End Page: 55
Language: English
DOI: 10.1002/jcb.240501311
PUBMED: 1305688
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Joel Sheinfeld
    254 Sheinfeld
  2. Victor Reuter
    1223 Reuter
  3. Alvaro S. Sarkis
    34 Sarkis