Intestine-associated antigens in ovarian tumours: an immunohistological study

Expression of E-cadherin and N-cadherin in surface epithelial-stromal tumors of the ovary distinguishes mucinous from serous and endometrioid tumors

This study examines the expression of E-cadherin and N-cadherin in the most common epithelial tumors of the ovary. The homotypic interactions of distinctive members of the cadherin family of cell-cell adhesion molecules segregate cells into tissues during embryonic development, and their expression in tumors can be used to trace the histogenesis of tumor cells. Because the surface epithelium of the ovary is a modified mesothelium, we speculated that the expression of E (epithelial)-cadherin and N (neural, mesodermal)-cadherin may provide clues about the controversial origin of common epithelial ovarian tumors. Immunohistochemistry was performed in paraffin sections using well-characterized monoclonal antibodies to E- and N-cadherin and heat-induced antigen-retrieval methods. We found that serous and endometrioid tumors express both E- and N-cadherin. In contrast, mucinous tumors strongly express E-cadherin, but no N-cadherin. The presence of N-cadherin in serous and endometrioid tumors traces their origin to the mesoderm-derived ovarian surface epithelium. The absence of N-cadherin in mucinous tumors clearly distinguishes them from the former, suggesting histogenesis from a cell lineage other than the ovarian surface epithelium or aberrant differentiation mechanisms associated with neoplastic transformation.

The immunoperoxidase localization of tumour markers in ovarian cancer: the value of CEA, EMA, cytokeratin and DD9

Primary tumours from 40 patients with epithelial ovarian cancer, treated at St Thomas's Hospital over a 10-year period, were studied for the immunocytochemical expression of the following tumour markers in formalin-fixed paraffin embedded material: carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cytokeratin (CAM 5.2), and DD9. An indirect immunoperoxidase staining technique was used. All of the tumours were positive for EMA and CAM 5.2, and 30% of them were positive for both CEA and DD9. The absence of CEA and DD9 may be of value in differentiating between metastatic abdominal adenocarcinomas of ovarian origin and those of gastrointestinal origin, but no indication of prognosis was obtained using these epithelial markers. The strong and widespread staining of all the tumours for EMA suggests that this may be a useful marker for detecting metastatic or recurrent disease by immunoscintigraphy.

A monoclonal antibody (D612) with selective reactivity for malignant and normal gastro-intestinal epithelium

We describe the generation and characterization of a monoclonal antibody (MAb), designated D612, with selective reactivity for malignant and normal gastro-intestinal epithelium. MAb D612, a murine IgG2a, was generated using a membrane-enriched fraction of a human colon carcinoma biopsy as immunogen. Employing radioimmunoassays (RIAs) of biopsy extracts to a range of normal and neoplastic tissues, and both immunofluorescence and immunoperoxidase assays on frozen sections of a range of normal and neoplastic tissues, we have shown that MAb D612 binds to 82% of colorectal carcinomas tested (n = 67) and to normal gastro-intestinal epithelium, but does not bind similarly to either neoplastic or normal tissues from a wide range of other sites. Western blotting has shown MAb D612 to react with a high-molecular-weight antigen. Live cell RIAs and FACS analyses demonstrate the reactive epitope to be present on the surface of colon carcinoma cells. Immunohistochemical studies have shown intense membrane staining of colon adenocarcinomas with MAb D612; the vast majority of both primary and metastatic colon adenocarcinomas from a variety of sites were positive with many lesions showing homogeneous staining of virtually all cells present. Using human effector cells, we also showed that MAb D612 mediates antibody-dependent cell-mediated cytotoxicity (ADCC) of human colon carcinoma cells; this activity was enhanced in the presence of interleukin (IL-2). Radiolabelled D612-purified IgG selectively binds a human colon carcinoma xenograft in situ. The pattern of membrane-associated staining, the molecular weight of the reactive antigen, the IgG2a isotype, the ability to mediate ADCC in the presence of IL-2, and the immunohistochemical and RIA studies demonstrating highly restricted reactivity to malignant and normal gastro-intestinal tissue, all distinguish MAb D612 from other MAbs thus far described.

Nuclear reactivity for estrogen. A possible diagnostic tool in differentiating colon cancer metastases in the ovary from primary mucinous ovarian tumors

Tissue distribution of carcinoembryonic antigen (CEA) and estrogen was analyzed in eight primary ovarian mucinous carcinomas, three primary mucinous colonic cancers, and four ovarian metastatic lesions from colonic and pancreatic adenocarcinomas. Primary ovarian mucinous carcinomas and metastatic colonic carcinomas had similar localization of CEA within the epithelial cytoplasm. Estrogen localization, in contrast, was shown within the epithelial nuclei of seven of eight primary ovarian mucinous tumors; whereas the nuclei of metastatic and primary mucinous colonic carcinomas did not have intranuclear estrogen. The cytoplasm and the stroma of both primary ovarian and metastatic colonic carcinomas stained for estrogen.

Carcinoembryonic antigen in primary and metastatic ovarian tumors

The immunoperoxidase method and an absorbed monospecific commercial rabbit anti-CEA antiserum were used to detect CEA in 105 primary ovarian tumors and 12 metastatic ovarian adenocarcinomas of intestinal origin. Primary ovarian tumors showed CEA in foci of squamous differentiation in 9 out of 10 cases of endometrioid carcinomas and focally in areas of intestinal differentiation in 21 out of 28 mucinous tumors as well as 4 out of 5 Brenner tumors. All of the serous tumors, clear cell carcinomas, and undifferentiated carcinomas as well as 19 of the 22 mucinous tumors without intestinal differentiation lacked CEA. All metastatic ovarian adenocarcinomas showed characteristic diffuse staining of CEA. Differences in CEA staining were found to be useful for histological differentiation between primary ovarian cancers and metastatic ovarian adenocarcinomas of intestinal origin. Furthermore, these data might be helpful in the selection of patients for serial CEA evaluation.

Intestinal mucin antigens in ulcerative colitis and their relationship with malignancy

The expression of two intestinal mucin-associated antigens large intestine mucin antigen (LIMA) and small intestine mucin antigen (SIMA) were investigated by indirect immunoperoxidase staining of rectal mucosa from patients suffering from ulcerative colitis with (n = 6) and without (n = 31) associated carcinoma and in noncolitic controls (n = 40). The aim was to assess the relationship between antigen patterns and malignant change. SIMA, which is localised predominantly in the small intestine, is virtually undetectable in the normal adult colonic mucosa. However, this antigen is present in the foetal colon and colonic carcinoma. LIMA is expressed in normal colonic mucosa, but absent from the small intestine. LIMA staining patterns were not significantly different among the three groups. In contrast, expression of SIMA was significantly higher in the patients who had developed carcinoma (6/6) than in the noncancer group (7/71) (P less than 0.001). The presence of SIMA was also significantly related to areas of dysplasia compared to normal (P = .03) or inflammation (P less than .05), but it did not differ from mucosa showing "indefinite" atypia. The finding of 31% SIMA-positive biopsies associated with severe inflammation in colitis with active disease, but no evidence of malignancy, is difficult to explain at the present stage. A followup study would be necessary to determine its significance. Perhaps the most important finding is the increased frequency of SIMA-positive foci in histologically normal mucosa in carcinoma patients compared with the noncancer group (P less than .001), suggesting a field change. These observations may be prove useful for the identification of patients who may be at risk of developing carcinoma.

Characterization of the specificity by immunohistology of a monoclonal antibody to a novel epithelial antigen of ovarian carcinomas

An immunohistological study, using the avidin-biotin-peroxidase complex method, was carried out to define the reactivity profile of a murine monoclonal antibody, MOv2, which recognizes a novel glycoprotidic antigen associated with ovarian epithelial tumors. Among the primary ovarian tumors tested, MOv2 immunostained 93% of mucinous and 75% of serous cystadenomas, 100% of mucinous, 81% of serous and 73% of endometrioid carcinomas. Undifferentiated and clear cell tumors revealed more limited reactivity with the antibody, whereas ovarian sex cord-stromal and germinal tumors were immunonegative. Positive reactions were also documented in omental metastases from primary ovarian carcinomas. No immunoreactivity was detected in normal ovarian epithelium, whereas the cells lining Walthard's nests adjacent to the fallopian tubes and a variety of normal epithelia were consistently immunolabeled. These included the lining epithelia of the gastrointestinal tract, bronchi and endocervix, and the epithelium of salivary, biliary and pancreatic ducts and sweat glands. To a lesser extent, positive reactions were detected in other surface epithelia, such as squamous and transitional epithelia. Among tumors other than ovarian, MOv2 consistently reacted with adenocarcinomas and squamous cell carcinomas from different sites, most notably breast, lung and gastrointestinal tract, and with transitional cell carcinomas. In contrast, no staining was demonstrated in non-epithelial malignancies. The antigen defined by MOv2 may be operationally useful as a marker of epithelial lineage in tumor histopathology. Its pattern of immunohistochemical distribution indicates that an antigenic phenotype shared by normal surface epithelia and non-ovarian carcinomas is strongly associated with common epithelial neoplasms of the ovaries.

Homoeotic transformations in man: implications for the mechanism of embryonic development and for the organization of epithelia

Homoeotic transformations are substitutions of one body part for another which arise during embryogenesis or regeneration. They are well known among the Arthropoda but are not generally thought to occur in Man or other vertebrates. In this paper the occurrence and characteristics of 21 types of epithelial heterotopia and metaplasia are reviewed and it is concluded that they are fully comparable with the homoeotic transformations of the arthropods.. The transformations are concentrated in the gastrointestinal, urinary and female reproductive systems and typically appear as foci of ectopic epithelium with a sharp discontinuity of cell type at the edges of the patches. Most of the transformations occur in renewal tissues and must therefore be interpreted as changes in the states of determination (epigenetic codings) of the stem cells rather than changes between already differentiated cells. Most, but not all, of the transformations are between tissues whose precursors are neighbouring regions of a common cell sheet during early embryogenesis and which are therefore likely to have neighbouring epigenetic codings. Following the Cairns hypothesis for epithelial organization it is proposed that stem cells themselves are protected against changes in epigenetic coding but their daughter cells, normally destined to differentiate and die, are not. Homoeotic transformations may thus occur in situations in which daughter cells become promoted to stem cells which happens either during the growth phase of the organism or during tissue regeneration in the adult.

Inappropriate mucin production in endodermal carcinoma--one point of view

The mucosal lining cells in the gastrointestinal tract respond to a threatening situation by secreting mucins manufactured during foetal life and this secretion is considered to be an early manifestation of cytogenetic instability and which may be the first step in the process of malignant transformation. Using immunohistological techniques and specific antisera against SIMA (small intestinal mucin antigen), LIMA (large intestinal mucin antigen) and CEA (carcinoembryonic antigen) the presence of these mucin antigens was studied in resected specimens from colonic, gastric and gall bladder carcinomas as well as in mucinous tumours of the ovary. Inappropriate or oncofoetal mucins were present in the majority of endodermal carcinomas, in associated metaplastic epithelium and premalignant lesions such as polyps. These antigens were also demonstrated in normal histological epithelium at some distance from the tumour. These findings lead to a better understanding of the biological behaviour of preneoplastic lesions of endodermal tissues and will aid in developing sensitive diagnostic tests for the presence of these substances.