Immunobiology of human bladder cancer

Preliminary identification of a tumor-associated glycoprotein in bilharzial bladder cancer urine

A tumor-associated antigen was preliminarily identified in urine from bilharzial (squamous-cell carcinoma) bladder cancer patients. Monospecific rabbit antisera were made by immunization with concentrated bladder cancer urine and exhaustive absorption with insoluble normal human serum and urine. The urine tumor-associated antigen was identical to an antigen from 3M KCl bladder tumor extract by immunodiffusion. The antigen in urine was found in nine of 10 bladder cancer patients and was absent from normal urine and serum by immunodiffusion and immunoelectrophoresis. The antigen was a concanavalin-A-binding glycoprotein which was anodal on immunoelectrophoresis. It was stable up to 2 years at -20 degrees C and did not cross-react with carcinoembryonic antigen or with Schistosoma haematobium antigens.

Urinary protein profiles in patients with urothelial bladder tumours

Urinary protein profiles were studied in 32 patients with urothelial bladder tumours, using immunonephelometry. In patients without residual or recurrent tumours a glomerular type of proteinuria was demonstrated. In patients with grade III-IV transitional cell carcinoma the glomerular proteinuria was more severe than in patients with grade I-II tumours. Increased excretion of low molecular weight proteins was observed only in patients with grade III-IV tumours. The use of the increased relative clearance of albumin, transferrin, and haptoglobin as a diagnostic test was attempted in detecting residual or recurrent tumours. In patients with grade III-IV tumours the predictive value of a positive or negative test was 92% and 100% respectively, whereas the relative protein clearance was without predictive value in patients with grade I-II tumours.

Detection of tumor-associated antigens in urine from patients with bladder cancer

An antiserum was prepared to a hypotonic saline extract of bladder tumor tissue which, after absorption with normal tissues, was used to localize tumor-associated antigens in a Sephadex G-150 elution profile of urine from patients with bladder cancer. A second antiserum was prepared to the urine fraction with tumor-associated antigens. After absorption with normal urine and plasma this antiserum was reacted in gel diffusion and complement fixation assays against urine samples from normal individuals, patients with bladder cancer and patients with proved urinary tract infections. In the gel diffusion assays none of the 23 urine specimens from normal individuals, 37 per cent of the 24 urine specimens from patients with urinary tract infections, 61 per cent of 13 urine samples from patients with papillomas and in situ tumors, and 95 per cent of 30 samples from patients with bladder cancer gave positive precipitin reactions. In complement fixation assays urine from 53 patients with papillomas through grade IV cancers showed a mean 50 per cent complement fixation at 30 micrograms. protein, 29 patients with urinary tract infections showed a mean 50 per cent complement fixation at 150 micrograms. protein and all but 6 urine specimens from more than 30 normal individuals showed 50 per cent complement fixation (mean value) at 140 micrograms. protein. Thus, an antiserum has been produced that may be used in assays for the diagnosis of bladder cancer.

Cellular immunity in bladder cancer patients

The leukocyte adherence inhibition test was used to evaluate the cellular immune status of 16 patients with a histological diagnosis of transitional cell carcinoma of the bladder. The reactivity of the leukocytes was measured against extracts of transitional cell carcinoma as well as renal cell carcinoma. The leukocytes of age and sex-matched control subjects, as well as patients with urinary tract infection, also were studied. The leukocytes of patients with transitional cell carcinoma were more reactive to extracts of transitional cell carcinoma. These results suggest that a response to tumor-associated antigens is present in transitional cell carcinoma patients.

Adenosine deaminase activity in patients with carcinoma of the bladder

Adenosine deaminase is an important enzyme in purine metabolism, and patients with abnormal lymphocyte and erythrocyte adenosine deaminase levels have been shown to have impaired immune competence. Since immune factors have been shown to be important in patients with transitional cell carcinoma of the bladder we studied adenosine deaminase activity in the hemic cells of 48 patients with this tumor. Lymphocyte adenosine deaminase levels were elevated in patients with transitional cell carcinoma and correlated with stage, activity, clinical course and tumor resection but not with tumor grade. Erythrocyte adenosine deaminase levels also were elevated in patients with transitional cell carcinoma but did not correlate with other disease parameters. Lymphocyte adenosine deaminase activity in patients with transitional cell carcinoma may be a sensitive indicator of disease activity and further studies may provide insight into the host-tumor relationship at the enzyme level.