Deletion of epithelial ABH isoantigens in primary gastric neoplasms and in metastatic cancer

Shared tumor antigens in colorectal carcinoma and neuroendocrine tumors

ND4 monoclonal antibody recognizes a tumor marker found on poorly differentiated colorectal cancer. We demonstrate its expression in 25% of gastrointestinal neuroendocrine tumors, which also express CEA in 37% of cases. As in colorectal cancer the ND4 marker is predominantly membrane bound in a colonic neuroendocrine tumor cell line, LCC-18 (p < 0.05). The ND4 marker is absent in a poorly differentiated colorectal cancer cell line that does not express CEA or other tumor antigens. Shed antigen in the serum of patients with neuroendocrine tumors is detected in only five of seven patients with the carcinoid syndrome and two of four of those without evidence of the syndrome. However, the reactivity was less in the patients with localized disease, and this test is unlikely to be of diagnostic utility in this group of patients. The sharing of this antigen in colorectal cancer and neuroendocrine tumors is not universal, but does support the common-cell progenitor theory for the origin of these tumors.

Tumor-associated blood group antigen expressions and immunoglobulins associated with tumors

As outlined in Figures 1 and 2, the biosynthetic pathways for the expression of the A, B and H, and the Lewis determinant carbohydrate sequence structures, as well as sialylated structures, involves both type 1 and type 2 precursor chains (which may be present as glycolipids and N- or O-linked glycoproteins), and many glycosyltransferases. For tumor cells, there appears to be increased expressions of fucosyl- and sialyltransferases yielding such structures as the Le(x), sialyl-Le(a), and many other similar determinants, which are not found on the normal cell progenitor of the tumor. The types of structures expressed on tumor cells is dependent on the particular fucosyl-, sialyl- and other glycosyltransferase genes activated in the transformation and tumor progression events, the availability of the substrates for the glycosyltransferases (both the precursor sequences and the nucleotide-sugar substrates) which is partly dependent on metabolites available to the tumor mass, and on the genotype of the individual regarding particular glycosyltransferases. Both the loss of A, B and/or H blood group antigen expressions of tumor cells and the relative expressions of the Lewis and sialylated-oligosaccharide determinants may be a consequence of the competing biosynthetic pathways and the glycosyltransferases for common substrate sequences, as well as due to the loss of particular glycosyltransferases concomitant with transformation. All of these factors probably account for the variable expressions of the complex of carbohydrate sequence determinants when comparing tumor sections of different individuals as well as the heterogeneity of expression of particular determinants within a single tumor tissue section. As described above, the A, B and/or H determinants, and the precursor sequences, are also expressed to differing extents on epithelial cells depending on the tissue type and cellular location in the tissue. Thus, the differentiation state of the particular epithelial cell also determines the quantity and types of carbohydrate sequences expressed. However, because of the complex nature of the competing biosynthetic pathways for the carbohydrate sequences of glycolipids and glycoproteins, and the relative activations of fucosyl- and sialyltransferases of tumor cells, it would seem that simple deductions as to the state of differentiation of particular tumors with A, B, H and precursor sequence expressions is not warranted.(ABSTRACT TRUNCATED AT 400 WORDS)

The occurrence of blood group substances (A, B, H, Le-a, Le-b) in salivary glands and salivary gland tumors. An immunohistochemical investigation

The distribution of blood group substances A, B, H, Le-a and Le-b in normal and neoplastic salivary gland tissue was evaluated by means of immunohistochemistry. The serological ABH blood group status of one third of the patients was known. Lewis blood group and secretory status were not known. In normal tissue, expression of blood group antigens corresponded to the serological blood group. Blood group substance H was present in almost every gland, regardless of the serological blood group. In submandibular glands, Le-b was rather selective for mucous acini. In tumors, a relationship of blood group expression to a glandular pattern and a high differentiation could be observed. Blood group substances were expressed at a high level in benign and highly differentiated malignant tumors. In poorly differentiated malignant tumors, they were mostly absent. Blood group expression evaluation could be of value in establishing the level of functional differentiation in salivary gland tumors.

Gastric endocrine cell hyperplasia and carcinoid tumors in pernicious anemia

Endoscopic screening in 123 patients with pernicious anemia (PA) yielded 4 patients with solitary and 1 patient with multiple gastric carcinoid tumors. Quantitative histologic studies of multiple standardized biopsy specimens showed a significantly increased number of fundic mucosal argyrophil endocrine cells in 40 patients with PA when compared with 15 patients with simple fundic atrophic gastritis (p = 0.002) or 8 normal controls (p = 0.0001). Patients with simple atrophic gastritis had increased numbers of fundic mucosal argyrophil cells as compared with normal controls (p = 0.02). A significant difference was also noticed in the number of antral mucosal argyrophil cells between patients with PA and normal controls (p = 0.01), but not between patients with PA and patients with simple atrophic gastritis. It is concluded that, in addition to having hyperplasia of gastric mucosal argyrophil endocrine cells, patients with PA run an increased risk of developing gastric argyrophil cell carcinoid tumors, which should be regarded as potentially malignant.

Gastric carcinoid (gastrinoma) associated with achlorhydria (pernicious anemia)

This report presents a case of multicentric gastric carcinoid (gastrin containing) tumors of the fundus associated with achlorhydria and pernicious anemia. It is suggested that stimulation of the antral G cells and possibly fundic argyrophilic cells by achlorhydria associated with atrophic gastritis may lead to hyperplasia, and eventually to neoplasia in the latter, in the form of gastric carcinoid with gastrin production.

Achylia and the development of gastric carcinoids

Twenty-four patients with gastric carcinoids were examined retrospectively with regard to the presence of achylia and pernicious anaemia (PA). Six patients (25%) had achylia preoperatively and half of these had an associated PA. The gastric carcinoids occurring in an achylic stomach were almost exclusively located to the corpus area and tended to be multiple. Further, the majority of cells in most of them were argyrophil (Sevier-Munger) positive, indicating that they were of the enterochromaffin-like cell type. At present, achylia with or without concomitant PA appears to be the most distinct condition associated with gastric carcinoids. The pathogenesis of these tumours which develop in an achylic stomach is discussed.

Distribution of blood group antigens A, B and H in ameloblastomas

The histologic distribution of blood group antigens, A, B and H was examined in ameloblastomas and normal mucosa from 15 patients. The blood group antigens were demonstrated with a semiquantitative immunofluorescence staining method. Blood group antigens A and B were absent in the ameloblastomas, whereas the spinous cells of the oral mucosal epithelium showed a positive reaction in correspondence with the patient's blood group. Blood group antigen H was demonstrated in 14 of 15 ameloblastomas from patients belonging to blood group A, B, AB or O. In the oral mucosal epithelium from these patients blood group antigen H in all cases was located to the cell membranes of the spinous cells. The present findings suggest that a difference in ability to synthesize blood groups antigen H and the blood group antigens A and B exists in the ameloblastoma.

The variability of blood group antigens in gastric carcinoma as demonstrated by the immunoperoxidase technique

In this study the immunoperoxidase technique was used to demonstrate the blood group antigens A, B and H in normal gastric mucosa and primary and metastatic gastric carcinomas. No clear relationship between tumour differentiation and preservation of blood group antigens was found. In some well differentiated tumours there was a marked loss of blood group substance, whereas in other poorly differentiated tumours, both primary and metastatic, it was easily detectable. In some tumours an inverse relationship between A or B and H activity was noted. This observation is consistent with the theory that in some malignant cells there is a blocking of the normal step-by-step elongation of the carbohydrate portion of blood group substances.

Pernicious anaemia in association with argyrophil (Sevier-Munger) gastric carcinoid

3 cases of pernicious anaemia in association with gastric carcinoid (in 1 case multiple) are described. All tumours were rich in argyrophil cells with the Sevier-Munger and Grimelius staining techniques, indicating that they might be of the enterochromaffin-like cell type. The possible causal relationship between pernicious anaemia and this type of argyrophil carcinoid is discussed.

Glycoprotein alterations in human colonic adenocarcinoma

A marked diminution in membrane glycoproteins containing blood group A activity was observed in colonic cancer tissues. This change was associated with a reduction of the enzyme responsible for its biosynthesis and a decreased concentration of N-acetylgalactosamine in the cancer tissues. Glycosidase activities were unchanged. In addition to the changes associated with blood group A, we also found a decrease in sugar content, alterations in other antigens, and changes in the levels of several glycosyltransferases in cancerous tissues.

The relationship between expression of epithelial B-like blood group antigen, cell movement and cell proliferation

Healing wounds in the oral mucosa of rhesus monkeys were examined by an immunofluorescence staining method to demonstrate the distribution of a blood group antigen cross reacting with human group B, and by labelling with tritiated thymidine to localize areas of cell proliferation. Within hours, blood group antigen reactivity was lost from epithelial cells adjacent to the wound margin. Reactivity was absent from the epithelial outgrowth into the wound, but returned with restoration of epithelial continuity. The zone of increased cell proliferation lay adjacent to, but outside of, the area of antigen loss. Antigen loss appeared to be associated with an area of increased cell movement, a finding of interest in relation to reports of antigen loss from epithelial tumors.

Selective loss of blood group antigens during wound healing

Frozen sections of healing wounds of the oral mucosa of 3 rhesus monkeys were examined by a double layer immunofluorescent technic for the presence of blood B-like antigens. Antigen activity was present in normal epithelium and in the epithelial outgrowth into the wounds but was absent from the outgrowth following treatment with lipid solvents. This finding suggests that glycoprotein but not glycolipid associated antigen is lost from the surface of epithelial cells during wound healing, a pattern of selective loss which may reflect a difference between regenerative and neoplastic lesions.

Comparative histochemistry of gastrointestinal mucosubstances

Two histochemical sequential staining techniques, Alcian blue-PAS (AB-PAS) and high-iron-diamine-Alcian blue (HID-AB), which differentiate neutral from sulfated and non-sulfated acid mucosubstances, were applied to sections from the gastrointestinal tract of eleven mammalian species, including man, to study patterns of distribution of gastrointestinal epithelial mucosubstances. The application of these techniques under uniform laboratory conditions enabled a detailed description of epithelial mucosubstances throughout the gastrointestinal tract relative to location in each species as well as a comparison of their distribution among various species. The results showed that all of the 11 species studied had a distinctly different distribution of epithelial mucosubstances throughout the entire gastrointestinal tract. These differences were most obvious in the stomach and duodenum. In each species, neutral mucosubstances were most evident in the stomach and acid mucosubstances in the intestines, with sulfomucins most prominent in the large bowel. Acid mucosubstances were noted in Paneth cell granules of rodent species only. These histochemical observations make available a uniform comparative basis for the normal distribution of mammalian gastrointestinal mucosubstances which should facilitate their study in diverse pathological conditions.

Immunologic approaches to the diagnosis of cancer

A variety of immunologic approaches can be applied to the diagnosis of human cancer, and these have the potential advantages of specificity and sensitivity. Many tumor distinctive markers have been detected in the circulation of cancer patients. Cancer patients frequently have detectably depressed immune competence, but also have cell-mediated and humoral immune reactivity against tumor-associated antigens. Radiolabeling of specific antibodies may allow localization in vivo of tumors. With each of these potential immunodiagnostic approaches, it is necessary to systematically evaluate the assays and determine their value for specific clinical applications.

Blood group antigens A and B in ameloblastomas, odontogenic keratocysts and non-keratinizing cysts

The expression of blood group antigens A and B has been studied in 8 ameloblastomas, 16 odontogenic keratocysts from patients with basal cell nevus syndrome, 11 odontogenic keratocysts from patients without the syndrome, and 12 non-keratinizing odontogenic cysts, using a double layer immunofluorescence staining technique. The amount of antigen in the lesions was compared with the content of antigen in normal buccal mucosa from each patient. All ameloblastomas reacted negatively, three cysts from the patients with the basal cell nevus syndrome reacted negatively, and the odontogenic keratocysts from patients without the syndrome as well as the non-keratinizing odontogenic cysts all gave a positive reaction.

Alterations of membrane glycopeptides in human colonic adenocarcinoma

Membrane glycopeptides were examined in human colonic adenocarcinoma and normal colonic mucosa. The carbohydrates of membrane glycopeptides were found to be markedly reduced in tumor tissue and the relative proportions of the various sugars were altered. Although all of the sugars were lower in tumor tissue when compared to the adjacent normal mucosa, galactosamine, fucose, and sialic acid were more significantly reduced. Examination of the blood group activity and lectin-binding properties of membrane glycopeptides revealed that specific carbohydrate structures had changed in the tumor tissue. Most striking of these changes was the disappearance of glycoprotein-associated blood group A activity. Assay of the enzyme responsible for synthesis of the blood group A determinant showed that this glycosyltransferase activity was greatly diminished in tumor tissue. A galactosyltransferase and a fucosyltransferase were also significantly lower in the tumor tissue whereas the levels of another galactosyltransferase and a sialyltransferase were unaltered. Glycosidase activities in the normal and tumor tissues were similar. The results show that an alteration in glycoprotein biosynthesis occurred during tumorigenesis that resulted in a modified membrane glycoprotein composition and that these changes are probably a reflection of reduced levels of the enzymes responsible for glycoprotein synthesis.