T-antigen. A prognostic indicator of high recurrence index in transitional carcinoma of the bladder

Glycan-targeted drug delivery for intravesical therapy: in the footsteps of uropathogenic bacteria

The human urothelium belongs to the most efficient biobarriers, and represents a highly rewarding but challenging target for local drug administration. Inadequate urothelial bioavailability is a major obstacle for successful treatment of bladder cancer and other diseases, yet little research has addressed the development of advanced delivery concepts for the intravesical route. A prominent example of how to overcome the urothelial barrier by means of specific biorecognition is the efficient cytoinvasion of UPEC bacteria, mediated by the mannose-targeted lectin domain FimH. Similar mechanisms of non-bacterial origin may be exploited for enhancing drug uptake from the bladder cavity. This review covers the current status in the development of lectin-based delivery strategies for the urinary tract. Different concepts for preparing and optimizing carbohydrate-targeted delivery systems are presented, along with important design parameters, benefits and shortcomings. Bioconjugate- and nano-/microparticle-based systems are discussed in further detail with regard to their performance in preclinical testing.

Expression of blood group-related antigens in neoplastic uterine cervix

Expression of blood group antigens in normal, displastic and tumoral uterine cervix from 35 hysterectomised women with carcinoma of the cervix was investigated; the results were correlated with patients' ABH phenotype and secretor status. We used an indirect immunoperoxidase technique and a panel of monoclonal antibodies and lectins directed against different antigenic specificities. Anomalous expression of blood group antigens in premalignant lesions from cervix was found. Partial loos of expression of blood group antigens and some lectins in different grades of cervical intraepithelial neoplasia, and a total loss of expression in CIN III and in infiltrating carcinoma of the cervix from secretor patients was revealed. The findings herein described confirm the importance of these antigens as tumour markers and they might be useful for the study of cervical carcinogenesis.

Thomsen-Friedenreich (T) antigen expression increases sensitivity of natural killer cell lysis of cancer cells

In this study, we demonstrate a correlation between T antigen expression on a panel of human carcinoma cell lines and their sensitivity to porcine NK cell lysis. Specifically, the more T antigen is expressed, the more sensitive the cancer cells are to porcine NK cell lysis. Furthermore, this correlation also exists for these cells and their ability to induce tumors in vivo. In this porcine animal model, the less T antigen is expressed, the more prolific the tumor growth in vivo and vice versa. Using the human colorectal adenocarcinoma cell line SW-48, we used limiting dilution to clone 2 populations of cells, one expressing high and the other low levels of T antigen, clones 143 and 111, respectively. In these cloned cells, the clone that expressed more T antigen was more NK-sensitive in vitro and weakly induced tumor growth in vivo. Inversely, the clone that expressed less T antigen clone was more NK-resistant in vitro and grew more prolific tumors in vivo. Using soluble T antigen in a competitive inhibition assay, there was a decrease in porcine NK cell killing of the T antigen+ human cell line Colo 320HSR. Taken together, these findings suggest a novel role for T antigen in the NK cell recognition of cancer cells, specifically as markers for NK sensitivity in carcinoma cell lines. The significance of T antigens as targets for NK cell-mediated lysis is novel and identifies NK cell-T antigen interactions as potentially significant in the immunotherapy of cancer and its associated metastases.

Differential expression of the cancer associated antigens T (Thomsen-Friedenreich) and Tn to the skin in primary and metastatic carcinomas

AIM

To study the immunohistochemical expression of the Thomsen-Friedenreich antigen (T) and its precursor, Tn, in the skin in various cancers.

METHODS

T and Tn antigens were studied with monoclonal antibodies in 91 primary premalignant and malignant lesions, 13 cases of Paget's disease, and 26 carcinomas metastatic to the skin. The material had been collected over a 10 year period, formalin fixed, and paraffin embedded. Diagnoses had been made after examination of standard histological sections, supplemented when needed by appropriate immunohistochemical staining.

RESULTS

21% and 29% of the primary cutaneous premalignant and malignant epithelial tumours expressed the Tn and T antigens, respectively. By contrast, 81% of metastatic carcinomas to the skin were Tn positive, while only 23% of them expressed the T antigen. All cases of Paget's disease were Tn positive but only 15% of them expressed the T antigen. The 21 nonepithelial tumours (including melanomas) were as a rule unreactive.

CONCLUSIONS

The accumulation of the precursor (Tn) antigen in tumours metastasising to the skin highlights the incomplete glycosylation of carbohydrate antigens occurring in these tumours. The predominant Tn versus T antigen expression appears to be a useful immunohistochemical feature which may aid in the differentiation of primary cutaneous carcinomas from metastatic tumours.

Pathology of transitional cell carcinoma of the bladder and its clinical implications

Transitional cell carcinomas are divided into superficial and muscle-invasive tumors. Most of them are superficial tumors, and approximately 15-20% are muscle-invasive carcinomas. Pathologists play a significant role in diagnosing bladder tumors and in reporting features important for determining prognosis. We will review the cytologic and histopathologic features that help determine prognosis, including depth of invasion, tumor grade, multicentricity, tumor size, and the presence of vascular/lymphatic invasion, blood group antigen expression, proliferative indices, and molecular markers. Brief mention will be made of specimen handling, interpretation, reporting, and histologic variants of transitional cell carcinoma.

Specificity analysis of murine monoclonal antibodies reactive with Tn, sialylated Tn, T, and monosialylated (2-->6) T antigens

T, Tn, and sialyated Tn (sTn) are pancarcinoma antigens, and increased expression of these carbohydrate epitopes has been correlated with a poor prognosis in several epithelial malignancies. Ten murine monoclonal antibodies have been generated to these antigens, and compared by ELISA and immunohistochemistry to established mAbs reactive with these antigens. Nine mAbs (3 IgM and 6 IgG) reactive with synthetic T-human serum albumin (T-HSA) were produced after immunizing BALB/c mice with a synthetic T-keyhole limpet hemocyanin glycoconjugate (T-KLH). An additional IgM mAb (145.22) was produced in mice immunized with erythrocytes isolated from a patient with Tn syndrome. Three IgM and six IgG1 mAbs reactive with T-HSA did not react with natural T antigen present on desialyated glycophorin. All three IgM and several IgG1 mAbs, however, did react with LS-174T, a mucinous colon carcinoma cell line, 647V, a human bladder carcinoma cell line, and TA3Ha, a murine mammary carcinoma cell line as well as fresh frozen colon carcinomas. MAb 145.22 reacted with both natural and synthetic sources of sTn and Tn, as well as with LS-174T cells and mucin deposits in 10/11 colon carcinomas on fresh-frozen sections. MAb B72.3 reacted strongly with ovine submaxillary mucin (OSM) and sTn-HSA, while mAb CC49, a second-generation mAb to TAG-72 carcinoma mucin, reacted strongly with OSM, less strongly with desialyated OSM, and only weakly with sTn-HSA, suggesting that the epitope specificity for mAb CC49 is distinct from that of B72.3.

Superficial bladder cancer: study of the proliferative nuclear fraction as a prognostic factor

The expression of the anti-proliferating cell nuclear antigen (PCNA) was examined in bladder specimens from 48 patients with superficial transitional carcinoma, with the use of the PC10 monoclonal antibody. In vesical tumours with good clinical behaviour, we found a median PCNA positivity of 7.1% with a range of 5-25%. In vesical tumours with high incidence of recurrence, the median was 36.6% with a range of 15-80%. In vesical tumours with a strong tendency to invasion, the median positivity for PCNA staining was 68% with a range of 40-92%. In conclusion, we believe that using PC10 immunostaining to determine a nuclear proliferative fraction is a quick and simple method of studying the prognosis of patients who have vesical tumours of low grade and low stage.

Prognostic value of an assessment of ABH(0) isoantigens and Thomsen-Friedenreich (TF) antigen expression in patients with urinary bladder tumours

The discriminating and prognostic value of the expression of ABH(0) and TF antigens in tumour cells of 76 patients with urinary bladder tumours was evaluated. In patients with superficial tumours the most frequently defined phenotype was ABH(-) TF(+) and in those with deep tumours ABH(-) TF(-). The lowest frequency of recurrences was seen in patients with TFCr(+) antigenic phenotype and no patient died in this group. The mean lifespan of patients with TF(-) tumours was shorter (21 months) than of those with TF(+) tumours. For detection of tumours with higher risk of recurrences an analysis of the combination of markers revealed to be more predictive than analysis of a single marker.

The role of tumor rejection antigens in host antitumor defense mechanisms

BACKGROUND

Normal cells undergo contact inhibition of growth when their surface molecules interact. Tumor cells, however, have undergone a mutation that prevents this arrest of growth upon contact inhibition and allows constant growth. Thus, growth inhibition fails to occur despite the interaction of surface molecules. In recent years a subgroup of these surface molecules has been of interest to cancer investigators. This subgroup has been termed the tumor rejection antigens (TRAs). As the name implies, these are specific to the tumor of origin and may direct the immune system of the host to target the tumor cells and kill them.

METHODS

A literature search was carried out on TRAs to ascertain the current thinking on the subject.

RESULTS

Initial studies of TRAs have revealed that some of them may be heat shock proteins (HSPs). In particular, grp96, a number of the HSP90 family, has been implicated. More recent studies, however, have shown that HSPs alone may not be immunogenic but may act as carrier proteins for tumor specific peptides.

CONCLUSION

Such findings have led to speculation that HSPs or their associated peptides may have a role in the diagnosis and/or treatment of specific cancers. Immunotherapy and bispecific antibodies in particular are areas in which HSPs may prove to be useful.

Use of sialylated or sulfated derivatives and acrylamide copolymers of Gal beta 1,3GalNAc alpha- and GalNAc alpha- to determine the specificities of blood group T- and Tn-specific lectins and the copolymers to measure anti-T and anti-Tn antibody levels in cancer patients

Sialylated or sulfated derivatives and acrylamide copolymers of blood group T-(Gal beta 1,3GalNAc alpha-) and Tn-(GalNAc alpha) haptens were studied for their interaction with the lectins of peanut (PNA), Agaricus bisporus-(ABA), Helix pomatia-(HPA) and Vicia villosa B4-(VVA), using asialo Cowper's gland mucin (ACGM), which contains both T and Tn epitopes, as the coating substrate in enzyme linked lectin assay. Both T and Tn copolymers (-40 haptens) showed high affinity and strict specificity; although the T-copolymer at 0.05-0.07 microM concentration caused 50% inhibition of interaction of either PNA or ABA with ACGM, there was little inhibition of the HPA and VVA interactions even at over 100 times that concentration. The Tn-copolymer at 0.02-0.05 microM inhibited HPA or VVA interaction with ACGM by 50% but gave virtually no inhibition of PNA and ABA binding. Sialyl, sulfate or methyl group substitution on C-6 of GalNAc of the T-haptene did not prevent interaction with PNA but almost abolished interaction with ABA. In contrast, sialyl or sulfate group on C-6 and sulfate on C-3 of Gal in Gal beta 1,3GalNAc alpha- inhibited almost completely the interaction of PNA with ACGM but had only a slight effect on the interaction of ABA; C-6 substitution with either sialic acid or sulfate on GalNAc alpha- almost abolished the interaction of both HPA and VVA with ACGM.(ABSTRACT TRUNCATED AT 250 WORDS)

Prognostic factors in pTa-pT1 superficial bladder tumours treated with intravesical instillations. The Dutch South-Eastern Urological Collaborative Group

OBJECTIVE

To identify prognostic factors that enable patients with superficial bladder cancer to be divided into groups who will probably respond to therapy and those who will not.

PATIENTS AND METHODS

In a prospective randomized study 387 patients with pTa-pT1 superficial bladder carcinoma received, after transurethral resection, intravesical instillations with immuno- or chemotherapy. A simultaneous computerized analysis of factors predicting the recurrence-free interval was performed. All these patients had negative random biopsies. Pretreatment factors analysed for recurrence were gender, age, history (primary or recurrent disease), location of tumour, number of tumours, pT-stage and grade. RESULTS MEDIAN: Follow-up was 27 months (range 12-56). During the follow-up period 37.2% of the patients had recurrence and eight patients (2.2%) had progression into muscle invasive disease. After a univariate analysis the number of tumours and location of the tumour in the bladder appeared to be a significant influence on the recurrence-free interval. Location of at least one of the tumours in the prostatic urethra, bladder neck, posterior wall, and trigone area was significantly related to a shorter recurrence-free interval; these areas were defined as high risk. Tumour stage showed borderline significance. By using multivariate methods to assess the relative importance of these factors, location of tumour in the high risk region was related especially to a short recurrence-free interval. The factor found to be of significance for the prognosis for recurrence was tumour multiplicity. Gender, age, history of recurrent disease, size of the largest tumour, tumour stage or grade gave no additional information about the risk of recurrence.

CONCLUSION

Prognostic factor analysis, as an auxiliary study of trials of patients treated for superficial bladder tumours, is mandatory. The prognostic factors related to recurrence-free interval found in this study, location of the tumour and multiplicity, may be of use in the stratification necessary for current protocol design.

Prognosis and treatment of T1G3 bladder tumours. A prognostic factor analysis of 121 patients. Dutch South Eastern Bladder Cancer Study Group

Patients with T1G3 bladder cancer have a considerable risk for recurrence and/or progressive disease. Until now no consensus has been achieved on the optimal treatment. Within the Dutch South Eastern Bladder Cancer Study Group, 155 patients with a T1G3 bladder tumour were seen between 1983 and 1988. After review of histology, 121 could be evaluated and recurrence-free interval was studied with regard to prognostic factors. Prognostic factors such as sex, age, blood group, abnormalities on intravenous urography, pretreatment tumour configuration, number of tumours, number of locations involved in the bladder, voided urine cytology, results of random biopsies and mitotic index were evaluated, using a multivariate analysis with the Cox proportional hazard model. During the follow-up period, 70 (58%) patients had recurrent bladder cancer, and of these 30 (43%) had progression into invasive disease. Of the possible prognostic factors analysed, only multiplicity (P = 0.03) and the number of locations of the tumours (P = 0.03) were independent prognostic factors in relation to the risk of recurrence. The recurrence-free interval was influenced by the therapy. For T1G3 tumours, additional intravesical immunotherapy/chemotherapy or radiotherapy after transurethral resection (TUR) increased the recurrence-free interval significantly. Because most other parameters did not show additional prognostic value, the T1G3 tumours can be considered as homogeneous with regard to prognosis. Only multiplicity and the number of locations involved added to the prognostic significance of patients with these bladder tumours. In addition, it is advisable to give patients with T1G3 tumours additional treatment after the initial TUR.

Tn antigen, a marker of potential for metastasis of uterine cervix cancer cells

BACKGROUND

The expressions of Thomsen-Friedenreich antigen (T-Ag) and Tn antigen (Tn-Ag), precursors of MN blood group antigens, were examined in the tissues of squamous cell carcinoma of the uterine cervix from 111 patients to determine their clinicopathologic significance with regard to the biologic behaviors of cancer cells and the clinical course of the patients.

METHODS

T-Ag and Tn-Ag were measured by the avidin-biotin-peroxidase (ABC) method with peanut (Arachis hypogaea) lectin (PNA) and Vicia villosa agglutinin (VVA), respectively.

RESULTS

Unlike expression of T-Ag, that of Tn-Ag was correlated closely with vascular permeation of cancer cells, their parametrial spread and metastasis to the pelvic lymph nodes, and also with a low 5-year survival rate. No correlation was found between expression of Tn-Ag and other parameters, such as the clinical stage or histologic type. Furthermore, Tn-Ag expression was independent of the degree of cancer involvement in the fibromuscular stroma of the cervix, which seems to be a marker of the aggressiveness of cancer cell proliferation.

CONCLUSIONS

These results indicate that Tn-Ag expression is a useful indicator of the potential for metastatic potential of cancer cells. Thus, a combination of estimations of the degree of cancer involvement in the cervical stroma and Tn-Ag expression seems the most useful for predicting the prognosis of patients with cervical cancer.

Localization and identification of T-(Gal beta 1-3GalNAc alpha 1-O-R) and T-like antigens in experimental rat bladder cancer

A mouse monoclonal antibody and a rabbit polyclonal antibody against the T-antigen (Gal beta 1-3GalNAc alpha 1-O-R) were used to study the distribution of T-antigens in an experimental rat bladder cancer model. Neoplasia was induced in 28 rats by intravesical installation of N-nitroso-N-methylurea (NMU) dissolved in acetate buffer. Fifteen rats were installed with acetate buffer, and served as controls. Urothelial samples were taken from all animals, the atypia was graded and detailed data on the location of the antibody binding structures were obtained by immunohistochemical methods. In addition, Western Blots of glycoproteins and thin-layer-chromatography (TLC) immunostainings of glycolipids extracted from normal and malignant tissue were performed to characterize the molecules presenting T-antigens. Examination of the histologic distribution of T-antigens showed that both the monoclonal and the polyclonal reagents reacted with atypical cells in proportion to the grade of atypia, but showed no reaction in invasive cells. These results confirm previously obtained data on the T-antigen using peanut (arachis hypogaea) agglutinin (PNA), and support the structure identity as being the classical O-linked mucin type T-antigen. Western blots of tumor glycoproteins showed that the monoclonal and the polyclonal antibody reacted with epitopes different from that of PNA, but all the probes correlated with atypia. In addition PNA, as the only anti-T reagent, bound to glycolipid. By using well characterized and highly specific immunological reagents the present study shows that the T-antigen is a highly selective marker of urothelial atypia.

Prognostic factors in survival of bladder cancer

Clinical and pathologic data of 36 patients with transitional cell carcinoma of the bladder were investigated to determine the significance on patient survival of these factors: pathologic grade and stage; the immunohistochemistry of eight cell and tumor markers; nuclear DNA flow cytometric parameters; and patient smoking status. The bivariate and multivariate statistical analysis significantly correlated patient survival rates with the immunohistochemical expression of blood group, isoantigens A (P less than 0.05), O(H) (P = 0.001), the oncogene-related protein ORP-p21 (P less than 0.05), the pathologic grade and stage (P = 0.002), and the tumor DNA ploidy (P less than 0.05). Smoking status correlated aneuploidy (P less than 0.05) and tumor expression of ORP-p21 (P less than 0.05) with the patient survival rate. Despite the relatively small number of patients in this study, the results suggest that the clinicopathologic variables are significant factors in survival of bladder cancer.

Nuclear volume and expression of T-antigen, sialosyl-Tn-antigen, and Tn-antigen in carcinoma of the human bladder. Relation to tumor recurrence and progression

The T-antigen system and the mean nuclear volume have been proposed as risk variables in bladder tumors. This study includes 34 patients with initially noninvasive (Ta) transitional cell carcinomas who experienced different courses of disease. Tissue specimens of primary tumors were analyzed for the expression of T-antigen, Tn-antigen, and sialosyl-Tn-antigen using monoclonal antibodies (MoAb) and the lectin peanut agglutinin (PNA) in an indirect immunoperoxidase method. In addition, the mean nuclear volume was estimated by morphometry. Tissue from 7 of 13 patients (54%) who had invasive disease during a follow-up period of 5 years expressed T-antigen, as defined by MoAb HH8 in the primary tumor, whereas tissue of only 3 of 21 patients who did not have invasive disease expressed the antigen (P less than 0.02). No association was found between tumor progression to invasion and the expression of Tn-antigen or sialosyl-Tn-antigen. Tn-antigen expression was partially lost in invasive tumors (P less than 0.03) when compared with the expression in primary noninvasive tumors. A high mean nuclear volume in tissue specimens of primary tumors correlated with a progression to invasive disease (P less than 0.01). A significantly (P less than 0.003) higher mean nuclear volume was found in tumor areas that were positive for PNA compared with areas that were negative for PNA in primary tumors. A significantly lower mean nuclear volume was found in Tn-antigen-positive invasive Grade 3 tumor areas than in Tn-antigen-negative areas (P less than 0.005). The combined use of T-antigen expression and mean nuclear volume is of potential clinical interest for determining patients who are at high risk of disease progression.

Tumor enzymes and prognosis in transitional cell carcinoma of the bladder: prediction of risk of progression in patients with superficial disease

The activities of 6 enzymes of carbohydrate metabolism were estimated in superficial transitional cell carcinomas from 103 patients undergoing transurethral resection of the bladder for the first time. The patients were followed by quarterly endoscopic examinations for a maximum of 81 months (median 33 months). During followup 24 patients had progressive disease. The activities of phosphofructokinase and phosphohexose isomerase were significantly lower in tumors from patients whose disease had superficially invaded the lamina propria (stage pT1) than in others in whom it was confined to the bladder mucosa (stage pTa). Similarly the activities of the 2 enzymes were significantly higher in well differentiated (grade 1) than in moderately well differentiated (grade 2) carcinomas. Univariate analyses using the log rank test showed that neither pathological stage nor malignancy grade of the carcinoma was a significant factor in predicting the risk of progression. Of the 6 enzymes, below median activities of phosphofructokinase, lactate dehydrogenase and phosphohexose isomerase were associated with a significantly increased risk of progression in these patients. Multivariate analyses using Cox's proportional hazards model showed that the activity of lactic dehydrogenase in superficial transitional cell carcinoma is an independent prognostic factor in predicting the risk of progression. It is postulated that the measurements of the activities of the 3 enzymes in tumors from patients with superficial transitional cell carcinoma might help to select individual patients with a high risk of progression for adjuvant intravesical treatments.

Expression of type 1 blood group precursor in human gastric carcinoma

The surface epithelium of normal gastric mucosa from patients with gastric adenocarcinoma expressed the type 1 blood group precursor only in Lewis (Le) non-secretor individuals, Le a+b- (se/se, Le/-) and Le a-b- (se/se, le/le). In secretors, the superficial mucosa was negative. Deep areas of the mucosa showed no type 1 precursor regardless of secretor status. Expression of type 1 precursor was anomalously found in neoplastic cells in 14 of 16 Le a-b+ (secretors) patients and in 4 of 5 Le a-b- (secretors) patients. The 1 Le a-b- non-secretor carcinoma expressed type 1 precursor strongly. 6 of 8 Le a+b- non-secretor carcinomas showed positivity for the monoclonal antibody K-21. Thus the type 1 precursor reacted with the non-neoplastic gastric surface of non-secretors but not with those of secretors, and also with most gastric adenocarcinoma regardless of secretor status and Lewis phenotype.

Lewis system alterations in gastric carcinogenesis

Alterations in the expression of type 1 blood group-related antigens (Lewis a and b) were examined immunohistochemically in 371 consecutives gastric biopsy and 80 surgical specimens from patients of gastric carcinoma. The ABH and Lewis phenotype and secretor status of the patients were correlated with histologic findings. An anomalous expression of Lewis a antigen was found in 88 of 249 gastric biopsy specimens of Lewis (a-b+) phenotype patients. The prevalence of this anomaly increased with the evolution of the premalignant process, in agreement with the commonly accepted model of gastric carcinogenesis. Thus, anomalous Lewis a antigen appeared in 66.6% of gastric dysplasia cases, in 64.6% of intestinal metaplasia, in 15.4% of atrophic gastritis, and in 7.4% of superficial gastritis. No alterations were found in subjects with normal gastric mucosa. Forty-seven of the 49 Lewis (a-b+) phenotype gastric carcinoma patients showed antigenic alterations in tumor cells (anomalous Lewis a antigen in 36 and loss of Lewis antigens in 11). In 26 of these gastric specimens an anomalous Lewis a antigen was present in areas of intestinal metaplasia and/or dysplasia away from the area of neoplastic transformation. The expression of Lewis a antigen in Lewis (a-b+) phenotype patients is a frequent phenomenon in gastric neoplastic cells and could result from the blocked synthesis of Lewis b antigen with accumulation of its precursors. These findings suggest that, during gastric carcinogenesis, antigenic alterations may precede neoplastic transformation. An anomalous Lewis a antigen could constitute a significant index of severity of the histologic lesion and contribute to identifying high-risk individuals.

Bladder cancer

Bladder cancer is largely a preventable disease; epidemiologic studies indicate that the majority of cases occur as a result of cigarette smoking or occupational exposures. The impact of screening high-risk populations is uncertain, but prompt and early diagnosis is essential for optimal therapeutic results. The management of different stages of disease varies greatly and is currently in a state of evolution. The majority of cancers are superficial, of low malignant potential, and can generally be treated cystoscopically. Few studies have addressed whether intravesical therapy will prevent high-risk patients with superficial disease from developing muscle invasion or distant metastases. Controversy exists as to optimal management of patients with invasive cancers. Improvements in technique and methodologies of urinary diversion have made cystectomy more tolerable for patients. Although cystectomy remains the "gold standard," probably not all patients require it. The careful selection of those patients whose bladders can be preserved is currently being evaluated. Combination chemotherapy for patients with metastatic bladder cancer is very active, appears to prolong survival, and may offer durable remissions to some patients. Whether chemotherapy will permit greater numbers of patients with invasive bladder cancer to be cured and bladders preserved remains to be determined.

Flow cytometric evaluation of Thomsen-Friedenreich antigen on transitional cell cancer using monoclonal antibody

In 31 transitional cell cancer (TCC) tissues and 5 normal bladder mucosae (NBM), we compared the results of flow cytometry (FCM) and immunohistochemical examination in evaluating the expression of Thomsen-Friedenreich antigen (T-Ag) using a monoclonal antibody. On immunohistochemical examination, 14 (45%) cancer tissues showed T-Ag, while 7 (23%) cancer tissues and all NBM showed only cryptic T-Ag, which was detected only after neuraminidase treatment. Ten (32%) high grade cancer tissues showed neither T-Ag nor cryptic T-Ag. ON FCM the T-Ag positive cells (TPC) and the T-Ag positive cells after neuraminidase treatment (nTPC) were counted in fresh cell suspensions. FCM was more sensitive than immunohistochemical study in detecting T-Ag. Additionally, FCM revealed that some tumors had both T-Ag and cryptic T-Ag at the same time. The ratio of nTPC to TPC was well correlated with the stage or grade of the tumor and may be a more reliable marker of TCC than the expression of T-Ag assessed by immunohistochemical techniques.

Are pancarcinoma T and Tn differentiation antigens?

Human fetal tissues were studied for presence of immunoreactive Thomsen-Friedenreich (T) and Tn epitopes (EPs) using well-defined anti-T and anti-Tn rodent monoclonal antibodies. T and Tn are universal (pan) carcinoma (CA) markers that are occluded in normal postfetal tissues except in some immunoprivileged enclaves. Immunohistochemical methods using avidin-biotin immunoperoxidase for staining were employed. Tissues between 45 and 117 days after ovulation were studied. In most instances, anti-T and anti-Tn antibodies showed similar immunoreactivity as demonstrated by positive immunohistochemical staining. The most intense staining was in epithelial and mesothelial components; the mesenchyme stained more faintly. All human sera have anti-T and anti-Tn antibodies, stimulated largely by intestinal flora. The presence of immunoreactive T and Tn during an early phase of fetal development, as shown here, and their known absence in noncarcinomatous postfetal tissues suggests that T and Tn, in addition to their association with CA, are stage-specific oncofetal antigens in pretolerogenic differentiation phases.

Binding of wheat and peanut lectins to human transitional cell carcinomas. Correlation with histopathologic grade, invasion, and DNA ploidy

The binding of peanut (PNA) and wheat germ (WGA) lectins to tissue sections was examined in biopsy specimens from normal urothelium (ten patients) and from tumor tissue of noninvasive (17 patients) and invasive bladder (31 patients) carcinomas. The results were correlated to DNA content, histopathologic grade, and the presence or absence of invasion. Significant alterations in lectin binding associated with the development of cancer were found. A gradual loss of both PNA and WGA binding was found to correlate with higher grades of atypia (P less than 0.001). The loss of WGA binding was significantly correlated with both tumor aneuploidy (P less than 0.001) and the presence of invasion (P less than 0.05), whereas no significant correlation was found between loss of PNA binding and these variables. We concluded that the loss of WGA binding structures associated with bladder cancer shows a better correlation with known risk factors (aneuploidy and invasion) than the loss of PNA binding does.

Enzyme studies in human transitional cell carcinoma of the urinary bladder

The activities of six enzymes of carbohydrate metabolism were estimated in tissue samples from 99 patients with transitional cell carcinoma of the urinary bladder undergoing transurethral resection. The results were analysed according to the stage of the disease and the malignancy grade of the carcinoma. There were statistically significant differences in the activities of three enzymes between various stages and grades. The activities of phosphofructokinase (PFK), alpha-glycerolphosphate dehydrogenase (alpha-GPDH), and phosphohexose isomerase (PHI) showed significant decreases with increased stage and grade. Of the total of 64 patients with superficial disease at presentation, five developed progressive disease during the course of this investigation. The activities of the three enzymes in these patients were compared to the median values for the group of patients with superficial disease. The activity of PFK was observed to be below the median value in all the five patients whereas the activities of alpha-GPDH and PHI showed similar patterns in four of the five patients. These preliminary data indicate that, in association with established clinical parameters, the measurement of the activity of these three enzymes may prove useful in selecting patients with an increased potential for developing progressive disease.