A, B, H antigen expression in transitional cell carcinomas of the urinary bladder

The prognostic value of A, B, H blood group antigen determination in superficial bladder cancer is unclear. Recent immunohistochemical studies employing monoclonal antibodies and Ulex Europaeus Agglutinin I (UEA-I) (Vector) have shown that A, B, H detectability and distribution in non-neoplastic urothelium are influenced by methodologic factors and, most importantly, by the secretor status. The authors investigated the A, B, H antigen in 93 tumors of the urinary bladder (78 secretors, 15 nonsecretors) and semiquantified the alterations from the expected normal expression on a scale from 0 to 3. Four O saliva nonsecretors as expected showed no staining and were excluded. Eighty tumors showed abnormal A, B, H expression and in 37 of these, A, B, H antigens were not detected. Tumors of A and O individuals showed statistically different reactivities, probably related to differences in the specificity of the employed A- and H-reagents. A, B, H expression was influenced by stage and grade (P less than 0.05, P less than 0.10) and was correlated to the clinical course of A but not O patients. These results, suggesting that alterations in the A, B, H expression occur early in the neoplastic development and follow the synthetic pathways in an opposite direction, emphasize that reagents recognizing blood group precursor substances, common to all individuals irrespective of the ABO and saliva secretor types, may increase the prognostic accuracy of blood group antigen determination in bladder cancer.