Blood group precursor T-antigen expression in human urinary bladder carcinoma

Tumor delection of the ABH blood group antigens (BGAg) heralds an unfavorable prognosis in human bladder cancer. The T antigen (Thomsen-Friedenreich antigen: T Ag), a precursor of other BGAg, has previously been found in malignant but not most normal cells, in which the TAg is cryptic but can be unmasked with neuraminidase (NMD). We investigated the prognostic significance of TAg expression in bladder cancer by staining paraffin sections with a T-specific lectin (peanut agglutinin [PNA]) immunoperoxidase technic. Seventy-two cases of low grade, low stage bladder cancer, 21 cases of high grade bladder cancer, and 68 controls were studied. All normals expressed the TAg only after NMD treatment (Cryptic TAg+). The Grade III cancers, all invasive, either expressed the TAg (TAg+) (67%) or lacked T even after NMD (Cryptic TAg-) (29%), indicating that the T structure was lost rather than masked as in normal tissue. Thirty-nine per cent of 23 Grade I and II cancers which were TAg+ or Cryptic TAg- subsequently became invasive (Stage B), compared with 10% of 49 Cryptic TAg+ cancers. For 32 Grade I and II, ABH BHAg negative cancers, 64% of TAg+ or Cryptic TAg- cancers became invasive, compared with 17% of cancers which had Cryptic TAg+. Thus, the TAg may be a prognostically useful immunohistochemical tumor marker in bladder cancer, especially for tumors negative for ABH BGAg.