lewis-x-antigen and Carcinoma-in-Situ

A study was made to determine the sensitivity and specificity of immunostaining of the Lewis X antigen in exfoliated urothelial cells from voided urine, for the detection and surveillance of bladder tumors.. Three consecutive voided urine specimens were obtained from 101 patients, 78 of whom were under surveillance because of a history of bladder tumors, and 23 were being evaluated because of hematuria or irritative urinary symptoms. Indirect immunoperoxidase staining of two urine samples was done on cytocentrifuge slides, using the P12 monoclonal antibody against the Lewis X antigen. The diagnosis of the presence of urothelial tumor was made if more than 5% of the cells showed a typical red-brown staining. Cytopathologic examination of the third urine specimen was done according to Papanicolaou. Each patient underwent cystoscopy, and biopsies were obtained whenever there was endoscopic evidence of bladder tumors or carcinoma in situ.. Cystoscopy and biopsies revealed transitional cell carcinoma in 32 patients, whereas 69 patients had no evidence of bladder tumors. Immunocytology of one urine sample showed true-positive results in 26 of the 32 patients with bladder tumors, corresponding to a sensitivity of 81.25%. When two samples were examined, a sensitivity of 97% and a specificity of 85.5% were obtained. When the results of cytology and immunocytology were combined, sensitivity reached 100%. High-grade and low-grade transitional cell tumors were detected with equal efficiency.. The use of P12 monoclonal antibody for evaluation of Lewis X reactivity in cytologic preparations from multiple voided urine specimens can improve the sensitivity of noninvasive detection of bladder cancer. The technique may ultimately replace cystoscopy in monitoring therapeutic response and tumor recurrence.

Topics: Biomarkers, Tumor; Carcinoma in Situ; Carcinoma, Transitional Cell; Humans; Immunoenzyme Techniques; Lewis X Antigen; Predictive Value of Tests; Sensitivity and Specificity; Urinary Bladder Neoplasms; Urine

Presented is a case report of a urinary bladder carcinoma that had an unusual morphology and phenotype. A 65-year-old Japanese man complained of gross hematuria. Cytological examination of the urine before a partial cystectomy revealed small, round atypical cells with a high nuclear/cytoplasmic ratio, scant cytoplasm, and hyperchromatic nuclei with coarse and granular chromatin in a bloody background. Several tumor cells had relatively large and vesicular nuclei with prominent eosinophilic nucleoli and obscure perinucleolar halos. A small number of large atypical urothelial cells were also recognized. The tumor recurred locally 3 months after the operation. The urine cytology during recurrence showed the same features without the atypical urothelial cells. These cytological findings suggested a case of small cell undifferentiated carcinoma (SCUC) combined with transitional cell carcinoma (TCC). An histology of the resected specimen before the recurrence revealed that the SCUC was consistent with a variant type of SCUC proposed for the lung and showed transition with TCC in situ. M-VAC chemotherapy after a total cystectomy was less effective. The patient died 6 months after diagnosis. A variant subtype of SCUC of the urinary bladder associated with TCC in situ has not been previously reported. Although this histological type is very rare, its earlier cytological detection is needed for appropriate therapy.

Topics: Aged; Biomarkers, Tumor; Carcinoma; Carcinoma in Situ; Carcinoma, Transitional Cell; Cytodiagnosis; Fatal Outcome; Humans; Immunohistochemistry; Keratins; Lewis X Antigen; Male; Microscopy, Electron; Neoplasm Recurrence, Local; Urinary Bladder Neoplasms

The expression of the cell adhesion molecule CD15 (also known as Lewis x) by breast cancers and by adjacent normal and benign breast epithelium was investigated in a series of 98 tumours. Immunohistochemistry was performed on paraffin sections using the anti-CD15 monoclonal mouse IgM antibody Dako-M1. Some 35% of cancers expressed CD15, as did 45% of normal and 60% of hyperplasia. No association was observed between cancer cell staining, or any epithelial staining (cancer, benign and normal), and tumour size, histological grade, nodal status, age at diagnosis or the frequency of 'events' (recurrence or death). Chi-squared tests in each case were non-significant. The pattern of CD15 expression by breast cancer was frequently associated with the leading edge of invading tumour or with the outer edge of boli of carcinoma in situ, possibly suggesting a potential role in invasiveness, and with cancer cells trapped intravascularly, possibly suggesting a role in metastasis.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma in Situ; Carcinoma, Ductal, Breast; Female; Granulocytes; Humans; Immunohistochemistry; Lewis X Antigen; Middle Aged; Neoplasm Invasiveness

Pokeweed mitogen (PWM) lectin, known to bind branched poly-N-acetyllactosamines, has a highly selective affinity for human colorectal carcinomas. We performed light microscopic (LM) histochemistry with PWM lectin on paraffin sections of human colorectal tissues. In histological sections, normal mucosae and adenomas with mild dysplasia exhibited negative reaction (0/10, 0/13, respectively) with or without neuraminidase pre-digestion, whereas adenomas with moderate dysplasia showed a small increase in PWM lectin reactivity after neuraminidase digestion (4/23). In contrast, we observed a high incidence of positive reactivity in colorectal carcinoma without neuraminidase pre-digestion (38/44). After digestion with neuraminidase, there was increased reactivity of colorectal carcinomas in situ (7/12) and invasive carcinomas (13/32). These results imply that human colorectal carcinomas consistently contain substantial amounts of PWM-reactive branched poly-N-acetyllactosamine glycoconjugates structures. We also compared the staining patterns of PWM lectin and monoclonal antibodies (MAb) directed to Lewis X (LeX) or Lewis Y (LeY) antigen. PWM lectin reactivity was largely confined to the apical membranes of carcinoma tissues. MAb-LeX or MAb-LeY immunoreactivity was seen on the apical membranes and in the cytoplasm of both adenomas and carcinomas. Therefore, histochemical studies with this lectin should be useful for identification of carcinoma tissues and analysis of glycoconjugates associated with colorectal carcinoma.

Topics: Adenoma; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Carcinoma in Situ; Colorectal Neoplasms; Female; Glycoconjugates; Histocytochemistry; Humans; Immunohistochemistry; Intestinal Mucosa; Lewis X Antigen; Male; Middle Aged; Pokeweed Mitogens

The staining patterns obtained with antiepithelial membrane antigen (anti-EMA) and the monoclonal antibody to 3-fucosyl-N-acetyllactosamine (AGF 4:48) in the uterine cervix in intraepithelial and invasive neoplasia were compared to determine a possible role in differential diagnosis of reactive and neoplastic conditions. Both early invasive and in situ adenocarcinoma stained equally intensely with both agents and both antibodies stained diffusely tubal metaplasia, endometrial lined glands, and even occasional areas of normal endocervical mucosa. It is concluded that these agents are unlikely to be of use in the routine histological differentiation of glandular and squamous cervical dysplasia or neoplasia, but immunostaining with anti-EMA may help differentiate between reactive and metaplastic changes in endocervical glands and adenocarcinoma in situ.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoma in Situ; Diagnosis, Differential; Female; Humans; Lewis X Antigen; Membrane Glycoproteins; Metaplasia; Mucin-1; Uterine Cervical Neoplasms