The variability of blood group antigens in gastric carcinoma as demonstrated by the immunoperoxidase technique

Effect of tissue fixatives on the immunohistochemical expression of ABH blood group isoantigens

Immunohistochemical analysis of ABH blood group isoantigens has been shown to be a useful ancillary technique for resolving problems associated with specimen mix-ups in the daily practice of surgical pathology. However, the effects of different fixatives on the expression of these antigens in paraffin-embedded tissues are not known. Therefore, the effects of seven different fixatives on the immunohistochemical expression of ABH blood group isoantigens were studied in tissues from several organs. The following fixatives were used: acetone, 70% ethanol, B5, Bouin, Carnoy, methanol, and 10% formalin. After fixation for 6, 12, and 72 hours, the tissue blocks were embedded in paraffin, and immunohistochemistry was performed on 4 microm-thick tissue sections using monoclonal antibodies to blood group isoantigens (A, B, and H) and the avidin-biotin detection method. Also, immunostaining was performed on step tissue sections with and without antigen retrieval using citrate buffer at pH 6.0. The expression of the blood group isoantigens was concordant with the blood group of the patient in all the cases studied, irrespective of the fixative and time of fixation. However, in the absence of antigen retrieval, the intensity of the staining reaction was diminished. These results showed that irrespective of the fixative used, immunohistochemical staining of paraffin-embedded tissue sections with ABH blood group antibodies is a rapid, reliable, and cost-effective method for sorting out interpretative problems of tissue contaminants (floaters) and specimen mix-ups in surgical pathology.

Immunostains for blood group antigens lack prognostic significance in T1 lung carcinoma

Recent reports have suggested that the retention of blood group antigen expression on tumor cells may be an important prognostic factor for survival. From 1986 to 1991, 136 patients underwent operative resection for their T1 N0 non-small cell lung carcinoma. One hundred twenty tissue blocks were available for antigen testing, and the histologic types were as follows: adenocarcinoma (73 patients), squamous cell (39 patients), large cell/undifferentiated (7 patients), and mucoepidermoid (1 patient). Follow-up is complete for all patients (mean, 41 months). This distribution of patients among the blood groups was as follows: A, 56 (47%); O, 53 (44%); B, 9 (7.5%), and AB, 2 (1.7%). Immunostaining was performed for A, B, and H blood group antigens. The 5-year actuarial survival in the blood group A patients (53%) did not differ significantly from that in the blood group O patients (59%). Similarly, when tumors were examined for their respective antigens, no significant differences were found in the 5-year survival of either blood group A or O patients between the tumors that retain and those that lose blood group antigen expression. Retention or loss of blood groups A or O antigen expression does not predict survival in patients with early-stage lung carcinomas.

Immunohistochemical study of blood group activities in the alimentary canal in normal and pathologic conditions with reference to the nature of epithelial mucopolysaccharides

ABO(H)- and Lewis-activities in the human alimentary canal were investigated by the avidin-biotin-peroxidase complex method using commercial mouse monoclonal antibodies in order to clarify (1) the changes apparent in these activities in carcinoma of the digestive tract or premalignant intestinal metaplasia of the stomach and (2) the relationship of the activities to the histochemical properties of epithelial mucins examined by Alcian blue (pH 2.5)/periodic acid-Schiff (PAS) double staining. In intestinal metaplasia, ectopic goblet cells showed various degrees of ABO(H)-activities according to the PAS stainability of mucins and revealed Lea-activity even in a Le(a-b+) group. In carcinoma of the alimentary canal, ABO(H)- and Lewis-activities compatible with the donors' blood groups were located mainly at the PAS-positive cell surface, and in the Golgi bodies and secretions. It was thus concluded that quantitative and/or qualitative changes in blood group activities were closely associated with those of epithelial mucopolysaccharides.

ABO (H) blood group antigen expression in gastric mucosa

The A, B, O (H) blood group antigens (BGA) are glycolipids present in the plasma membranes of many different epithelial cells. Alterations in BGA expression have been described in malignant tumors and premalignant lesions. We have studied ABO (H) BGA expression in paraffin sections of gastric specimens using immunofluorescence techniques with monoclonal antibodies. 102 patients were studied. 15 with normal mucosa (NM); 16 with duodenal ulcer (DU); 23 with gastric ulcer (GU); 11 with pernicious anaemia (PA) and 37 with adenocarcinoma (AC). The expression of BGA in normal gastric mucosa is detected in surface epithelium, mucoid cell neck glands and parietal cells as well as 2/3 of antral glands. BGA expression in DU gastritis is very similar to that seen in NM. In atrophic chronic gastritis associated with GU and PA there is a significant decrease in BGA expression. In patients with PA, BGA expression is greater in antral mucosa than in fundic mucosa. Loss of BGA expression is more pronounced in atrophic chronic gastritis surrounding AC. Intestinal metaplasia shows variable BGA expression. Our results support the hypothesis that loss of BGA expression by epithelial gastric mucosal cells may be related to alterations in cellular differentiation and premalignant potential.

Biological tissue markers in benign and malignant disease of the human prostate

Immunoperoxidase techniques were used to study, the distribution of peanut agglutinin receptors, blood group isoantigens and several epithelial antigens in hyperplasia, adenosis, microcarcinoma and well differentiated adenocarcinoma of the prostate. Intraluminal and luminal surface PNA receptors were seen in all well differentiated carcinomas, 53% of microcarcinomas and 50% of adenosis, while no such sites could be demonstrated in benign hyperplasia. The expected blood group isoantigen was expressed in 75% of benign hyperplasias. When compared to the hyperplastic epithelium nearby, appropriate ABH expression was seen in 60% of adenosis, 47% of microcarcinomas and 25% of well differentiated carcinomas. A keratin antibody specifically labelling the basal cells in the normal prostate identified a subset of well differentiated carcinomas with preferential staining of the apical cytoplasm while microcarcinomas and adenosis were consistently negative. Our study establishes a highly ordered PNA receptor distribution in prostatic epithelia; it confirms early changes in the expression of ABH isoantigens in epithelial proliferative disorders of the prostate; it identifies a subset of keratin-positive well differentiated carcinomas, possibly of different ontogeny.

Relation of blood group carbohydrates to differentiation patterns of normal and pathological odontogenic epithelium

The distribution of epithelial cell surface antigens was studied in normal odontogenic epithelium from 20 fetuses and in odontogenic epithelium from 15 ameloblastomas, 16 odontogenic keratocysts, 15 follicular and 15 radicular cysts. The cell surface carbohydrates were detected using antibodies with reactivity for the blood group antigens A, B, H type 2 (A and B precursor) and N-acetyllactosamine (N-lac, H type 2 precursor) by an immunofluorescence technique. The expression of the blood group carbohydrates differed considerably in normal fetal odontogenic epithelium from that in ameloblastomas and odontogenic cysts. The A, B and H type 2 antigens were demonstrated in odontogenic keratocysts and in follicular and radicular cysts. Expression of the blood group carbohydrates was similar in follicular and radicular cysts but differed from that seen in odontogenic keratocysts by the failure to detect N-lac in the latter. The antigens A, B, H type 2 and N-lac were not expressed in any of the ameloblastomas including types with palisading of basal cells and polarization of basal cell nuclei and types with a plexiform pattern with cuboidal or polyhedral shaped peripheral cells. The findings indicate that epithelium of ameloblastomas can be distinguished from odontogenic cyst epithelium by differences in expression of cell surface carbohydrates with blood group specificity.

Altered H-antigen reactivity as an early indicator of malignant transformation in oral epithelium

This study was undertaken to determine whether or not the blood group H-antigen reactivity of oral epithelium has value in predicting malignant transformation. Tissue from 3 groups of patients was studied retrospectively, using an immunoperoxidase technique. Two biopsy specimens from each patient, obtained at different times but from the same site, were examined for the presence of H-antigen. Group I consisted of 16 patients in which the initial biopsy was histologically benign, but the subsequent biopsy revealed epidermoid carcinoma. The initial biopsies in Groups II (17 patients) and III (17 patients) revealed epithelial dysplasia. Whereas the subsequent biopsy in Group II revealed carcinoma, the subsequent biopsy in Group III remained non-invasive. Normal epithelium from 64 patients was also studied. The results showed that in normal epithelium, H-antigen-negative cells are rarely seen, but 81% of the initial benign specimens of Group I showed antigen-negative areas. Therefore, it was concluded that altered H-antigen reactivity in histologically benign epithelium may serve to predict eventual malignant transformation, and that immunologic dedifferentiation precedes histologic dedifferentiation. A comparison between the initial biopsy specimens of Groups II and III yielded nearly identical results and showed that it was not possible, on the basis of the H-antigen reactivity, to predict which dysplastic lesions would progress to epidermoid carcinoma.

Cellular localization of lectin-affinity in tissue sections of normal human duodenum

Peroxidase (HRP) conjugates of Arachis hypogaea agglutinin (PNA), Dolichos biflorus agglutinin (DBA), Ulex europaeus agglutinin I (UEA I) and Bandeiraea simplicifolia agglutinin I (BSA I) were used to detect the expression of carbohydrate moieties in glyco-conjugates of normal human duodenal mucosa. Lectin histology was performed on sections from paraffin embedded specimens of donor blood groups A, B, AB and 0. While PNA, DBA and UEA I staining appeared to be independent of the donor blood groups, BSA I affinity was restricted to the blood groups B and AB. Neither striated columnar cells nor goblet cells stained with PNA-HRP conjugates. Glyco-conjugates of goblet cell mucins reacted with DBA and UEA I, but staining intensities varied in crypts and villi: positive goblet cells occurred preferentially in upper parts of the crypts and in villi. Striated columnar cells also exhibited variation in staining intensities, with binding of DBA and UEA I observed in the upper half of crypts and in villi, occurring predominantly along the brush border and in apical parts of the cells. Glyco-conjugates synthesized by Brunner's gland cells possessed a great variety of lectin reactivity with the lectins employed. Within a given histological section positive gland areas with different staining intensities beside negative cell populations might reflect different functional states.

Blood group antigens in vascular tumours. Evaluation of the immunoperoxidase technique

Determination of blood group isoantigens A, B and H, was performed in benign and malignant vascular tumours of the skin and subcutaneous tissue, using the immunoperoxidase technique. No differences were noted between benign haemagioendotheliomas from children or adults: neither tumour showed the presence of antigens in intercapillary cells. Reactive conditions such as angiolymphoid hyperplasia with eosinophilia showed an intense positive reaction to blood group substances of the endothelial proliferative cells. In malignant tumours no relationship between tumour differentiation and loss of blood group isoantigens was seen. Cases of Kaposi's sarcoma did not show antigens in spindle cells or capillaries but in medium sized vessels variable preservation or loss of blood group isoantigens was found.