Variability in the expression of the O(H) antigen in human transitional epithelium

In many organs the so-called blood group antigens A, B and O(H) are constituents of the surface of normal epithelial cells. Deletion of these antigens in cases of carcinoma may serve as a clinically useful tumor marker, especially in cases of carcinoma of the bladder. Further progress is hampered by uncertainty concerning the detectability of A, B and H tissue isoantigens on normal urothelium in tissue sections. The authors examined the expression of these tissue isoantigens on normal ureteral urothelium obtained at autopsy from 68 adults using the specific red cell adherence test and found that they were not detectable in normal urothelium from a significant fraction of individuals in blood group O and that results in blood groups A, B and AB also were somewhat variable. The variability did not appear related to the secretor status or postmortem interval. The results suggest that the current specific red cell adherence test may not be suitable for detecting deletion of tissue isoantigens in bladder tumor patients in blood group O.