Blood group antigens in urothelium in transitional cell carcinoma

A study is reported relating clinical behavior of transitional cell carcinoma of the urinary bladder to blood group substance expression on the surface urothelium using an immunoperoxidase technique. Eighty-seven biopsies from 60 patients were studied. An average follow-up of 84.7 months was obtained. Blood group substance was detected in 61 percent of low grade (I) tumors and in 41 percent of high grade (II to III) tumors. Low grade (I) tumors which exhibited the blood group substance followed a benign clinical course in 70 percent of the cases and an aggressive clinical course in 30 percent. The high grade (II to III) tumors which exhibited blood group substance followed a more benign clinical course in 54 percent of the cases whereas behavior was clinically aggressive in 46 percent. It is concluded that the presence of blood group substance on urothelial malignancies, although appearing to correlate in some degree with the aggressiveness of the disease, is not statistically significant in all tumor grades and is not an absolute finding that can be clinically used in a prospective manner to determine prognosis and treatment for the individual patient. The expression of this antigen does not appear to be statistically significant in low grade (I) lesions as previously reported; however, it may play a more important role in considering higher grade (II to III) lesions.