Detection of ABH tissue isoantigens by immunoperoxidase methods in normal and neoplastic urothelium. Comparison with the erythrocyte adherence method

The expression of the ABH blood group antigens (BGAg) by carcinomas of the urinary bladder at the time of initial biopsy heralds a relatively benign clinical course, whereas antigen deletion in histologically similar tumors is often predictive of tumor recurrences and invasion. The use of BGAg as a tumor marker in the clinical setting has been limited by difficulties in demonstrating BGAg in tissue sections with the erythrocyte adherence test, especially for antigen H. In this study, immunoperoxidase methods were used to detect BGAg in deparaffinized tissue sections of normal and malignant human urothelium, and the results were compared with those of the erythrocyte adherence test performed on adjacent sections. Results with the two methods were similar for antigens A and B; however, a novel lectin-antilectin immunoperoxidase method was clearly superior for detecting antigen H. The immunoperoxidase method significantly reduced false-positive test results for antigen deletion in normal urothelium and more accurately predicted the subsequent clinical course in patients having urinary bladder cancer.