lewis-x-antigen and Rectal-Neoplasms

We report a case of an 81-year-old immunocompetent Mexican man who underwent an abdominal-perineal rectal resection for a mass clinically thought to be carcinoma. Histopathologic diagnosis revealed classical Hodgkin lymphoma, nodular sclerosis type, involving the rectum. The diagnosis was confirmed by immunohistochemical studies that showed that the neoplastic cells were positive for CD15 and CD30 and negative for CD45 (LCA). In situ hybridization for Epstein-Barr virus small-encoded RNA was also positive in the neoplastic cells. Hodgkin lymphoma arising in the rectum of immunocompetent patients is rare, with only 12 cases (including this one) reported in the literature. Of these, the diagnosis was confirmed by immunohistochemical studies in only two cases, and this is the first case assessed and shown to be positive for Epstein-Barr virus.

Topics: Aged; Aged, 80 and over; Biomarkers, Tumor; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Male; Rectal Neoplasms; RNA, Viral

We have previously demonstrated tumor-specific alpha1,2fucosylation, which is associated with resistance of tumor cells to anticancer treatment in human colorectal tumor tissues. By using the YB-2 monoclonal antibody, the resulting products have been identified as Y, Le(b), and H type 2 antigens in colorectal tumor tissues.. Immunohistochemical analyses of colorectal cancer tissues (74 specimens) were performed with a newly established mouse monoclonal antibody, YB-3 specifically recognizing H disaccharide (Fucalpha1,2Galbeta) structures, and anti-A, anti-B, YB-2, and anti-sialyl Lewis X (SLX) antibodies, together with the analyses of glycosyltransferases involved in the synthesis of ABH antigens in the same tissues.. The YB-3 antibody enabled us to detect colorectal tumors, particularly tumors in the distal large intestine and the rectum, with high sensitivity (74.3%) and specificity (100%). From immunohistochemical and enzymatic analyses of colorectal tissues, we found that once alpha1,2fucosylation had proceeded in tumor tissues, blood group A or B antigen was also synthesized in approximately half of the tissues of A or B blood type, but not in their normal tissues. A correlation of survival rate with immunostaining of tissues was found only by YB-3 antibody and not by anti-A, anti-B, or anti-SLX antibody.. As a predictor of postoperative prognosis of patients with colorectal cancer, immunodetection of alpha1,2fucosylated antigens with the YB-3 antibody seemed to be superior to blood groups A, B, or SLX antigen in colorectal tumor tissues.

Topics: ABO Blood-Group System; Antibodies, Monoclonal; Antigens, Neoplasm; Biomarkers, Tumor; Colonic Neoplasms; Disaccharides; Female; Forecasting; Fucosyl Galactose alpha-N-Acetylgalactosaminyltransferase; Glycosyltransferases; H-2 Antigens; Humans; Lewis Blood Group Antigens; Lewis X Antigen; Male; Oligosaccharides; Prognosis; Rectal Neoplasms; Sialyl Lewis X Antigen

This study was performed to define selection criteria for adjuvant therapy in rectal cancer.. An immunohistochemical analysis using nine monoclonal antibodies against CEA, CD15s, CD44v6, DCC, E-cadherin, EGF-R, NM23, PAI-1, and P53 was performed on paraffin sections of two matched (age, gender, UICC stage [I-III], year of operation [1982-1991]) groups of patients (n = 2 x 64) with rectal carcinoma curatively treated by surgery alone. The two groups differed only with regard to metachronous distant metastatic spread. In order to exclude the influence of surgery, all patients had to meet the selection criterion "free of locoregional disease." Follow-up was prospective (median 80 months). Conventional staining procedures and immunohistochemical evaluation were used. Tumor grading and lymphatic and extramural venous invasion were also investigated. Analysis was performed with Fisher's exact test and Kaplan-Meier estimates of disease-free survival (log rank). The Cox model was used for multivariate analysis.. In univariate analysis only grading (P < 0.001) and extramural venous invasion (P < 0.001) correlated significantly with metachronous metastases. In multivariate analysis, beside grading (P = 0.010) and extramural venous invasion (P = 0.011), CD15s (P = 0.042) was also of significance. All other immunohistochemical markers failed.. The histopathological parameters grading and extramural venous invasion appear to be acceptable predictors of metachronous distant spread in curatively resected rectal cancer. In contrast to the immunohistochemical markers, grading seems to better reflect the individual tumor phenotype and its behavior.

Topics: Adult; Aged; Aged, 80 and over; Archives; Cadherins; Carcinoembryonic Antigen; Cell Adhesion Molecules; DCC Receptor; Disease-Free Survival; ErbB Receptors; Female; Follow-Up Studies; Glycoproteins; Humans; Hyaluronan Receptors; Immunohistochemistry; Lewis X Antigen; Lymphatic Metastasis; Male; Middle Aged; Monomeric GTP-Binding Proteins; Multivariate Analysis; NM23 Nucleoside Diphosphate Kinases; Nucleoside-Diphosphate Kinase; Plasminogen Activator Inhibitor 1; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Receptors, Cell Surface; Rectal Neoplasms; Staining and Labeling; Transcription Factors; Tumor Suppressor Protein p53; Tumor Suppressor Proteins; Veins

Topics: Adenocarcinoma; Antigens, Neoplasm; Carcinoma, Papillary; Colonic Neoplasms; Humans; Immunohistochemistry; Lewis Blood Group Antigens; Lewis X Antigen; Rectal Neoplasms; Thyroid Neoplasms

Liver metastasis from colorectal carcinoma is an important problem in surgical treatment and profoundly affects the prognosis of patients. If it were possible to identify characteristic features in the primary lesion strongly related to liver metastasis, these could be used as prognostic markers for liver metastasis. To search for such features, the primary lesions of patients with colorectal carcinoma with liver metastasis were investigated.. Three groups of colorectal carcinoma were examined: Group A with synchronous liver metastases; Group B with only lymph node metastases without recurrence for 5 years; and Group C with recurrence of liver metastases. Groups A and B included 24 cases and Group C, 20. We focused on cancer cell morphology at the invasive front and expression of sialyl Lewis X (sialyl Lex) in the primary cancer.. At the invasive front in Group A it was frequently found that polygonal, not columnar, cancer cells with a single or solitary trabecular form with indistinct polarity, showed an infiltrative growth pattern. This type of morphology was termed "focal dedifferentiation" and graded four levels. Eleven of 24 cases (46%) had severe focal dedifferentiation in Group A, 1 of 24 (4%) in Group B, and 6 of 20 (30%) in Group C. Sialyl Lex staining was positive in 12 of 24 cases (50%) in Group A, in 3 of 24 cases (13%) in Group B, and in 7 of 20 cases (35%) in Group C in the primary carcinoma. In respect to the staining of (sialyl Lex) at focal dedifferentiation, it was positive in 17 of 24 cases (71%) in Group A, in 4 of 24 cases (17%) in Group B and in 11 of 20 cases (55%) in Group C. Focal dedifferentiation and sialyl Lex staining in the primary cancer showed a significant difference between Groups A and B. Sialyl Lex staining at focal dedifferentiation showed a significant difference between Groups A and B and Groups B and C. Other adhesion related molecules, sialyl LeA and CEA, showed no difference among Groups A, B, and C.. Both focal dedifferentiation and expression of sialyl Lex antigen in the primary lesion are considered good markers for assessing the metastatic proclivity of colorectal cancer.

Topics: Adult; Aged; Biomarkers, Tumor; Carcinoma; Colonic Neoplasms; Female; Gene Expression Regulation, Neoplastic; Humans; Lewis Blood Group Antigens; Lewis X Antigen; Liver Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Oligosaccharides; Prognosis; Rectal Neoplasms; Sialyl Lewis X Antigen

Expression of Le(a) (Lewis(a)), Le(b) (Lewis(b)), X (Lewis X), Y (Lewis Y), SPan-1 and CEA was detected by an immunohistochemical method using a panel of antibodies in paraffin-embedded materials from 45 rectal adenocarcinomas and the corresponding normal mucosa. The relationships between antigen expression and grade of differentiation and survival were analyzed. Compared to the expression in normal mucosa, the expression of Le(a) was decreased in tumors while the expression of Le(b), X, Y. SPan-1 and CEA was increased. The expression of Le(a) and SPan-1 was associated with the grade of differentiation (p = 0.0001 and p = 0.02, respectively). Positive expression of Le(a) and SPan-1 correlated with poor prognosis (p = 0.0001 and p = 0.002, respectively), but positive expression of Y predicated favorable prognosis (p = 0.01). Our findings indicate that some of the tumor-related antigens might provide information important for the diagnosis, determining histologic differentiation and prognosis in rectal adenocarcinomas.

Topics: Adenocarcinoma; Antigens, Neoplasm; Carcinoembryonic Antigen; Cell Differentiation; Humans; Immunoenzyme Techniques; Intestinal Mucosa; Lewis Blood Group Antigens; Lewis X Antigen; Rectal Neoplasms

A comparative immunohistochemical study was performed to analyse the expression of cancer-associated carbohydrate antigens by primary and metastatic lesions of colon cancer. We used monoclonal antibodies which reacted with Lea, Lex and Tn as well as their sialylated derivatives. Twenty-one primary lesions in patients without metastasis and 26 primary and metastatic lesions in patients with liver metastasis were studied. Sialyl Lea was expressed by 57% of the primary lesions of patients without metastasis, 65% of the primary lesions of patients with metastasis and 73% of their liver metastases. Sialyl Lex was expressed by 60% of the primary lesions of patients with and without metastasis as well as by approximately 80% of the liver metastases. Sialyl Lea and sialyl Lex showed strong expressions in the liver metastases, significantly greater than in the primary lesions. The findings indicate the increased expressions of sialyl Lea and sialyl Lex to be correlated with liver metastasis of colorectal cancer.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Antigens, Tumor-Associated, Carbohydrate; Biomarkers, Tumor; CA-19-9 Antigen; Colonic Neoplasms; Female; Gangliosides; Gene Expression Regulation, Neoplastic; Humans; Lewis Blood Group Antigens; Lewis X Antigen; Liver Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Rectal Neoplasms

The monoclonal antibodies C14 and C365 which define the Y hapten and specific carcinoembryonic antigen (CEA) were shown by ABC-immunohistochemical technique to stain positively the tissue sections in 48 of 56 cases (85.7%) of rectal carcinoma for Y hapten, in 51 cases (91%) for CEA, and 100% for both together. Cancer cells which expressed Y hapten were mainly distributed in the foreland and deep invading cancer tissue which showed high ability of malignant growth. Two patterns of localization on the cancer cells for Y hapten were found: local distribution in cytoplasmic Golgi region, similar to blood group antigens, and diffused distribution on the membrane and in the cytoplasm as CEA. Positive expression of Y hapten on the carcinoma associated with types of differentiation and Duke's pathology stages: highly expressed on the poorly differentiated cancer and in Duke's A and C stages (P less than 0.05). Phenotypes of Y hapten and CEA on metastatic cancer cells in lymph nodes and primary cancers were similar. Our findings indicate that the antibodies may be useful in immunodiagnosis and immunotherapy.

Topics: Adenocarcinoma, Mucinous; Antibodies, Monoclonal; Carcinoembryonic Antigen; Carcinoma, Intraductal, Noninfiltrating; Humans; Immunohistochemistry; Lewis X Antigen; Rectal Neoplasms

Colorectal primary carcinomas and metastases from 20 Dukes' stage C or D patients were examined for the immunohistochemical localization and contents of various fucosylated N-acetyl-lactosamine oligomers by specific monoclonal antibodies (MAbs). MAbs used were SH1, specific for Lewis X antigen; FH4, specific for dimeric Lewis X antigen; FH6, specific for sialyl-dimeric Lewis X antigen; and KH1, specific for Lewis Y-Lewis X antigen. The distribution of the carbohydrate antigens identified by these MAbs was heterogeneous within the primary tumor as well as within the metastatic lesion. Examinations of serial sections indicated that areas within an individual tumor which were stained with one MAb were not always reactive with the other MAbs, although these four MAbs identify closely related structures. The degree of MAb reactivity with carcinoma sections was classified by percentage positive carcinoma cells, and primary tumors and metastases from the same patients were compared. An equivalent or higher proportion of carcinoma cells in the metastatic lesions were reactive with MAb FH6 than in the primary colon carcinomas, but each correlation was not seen with the other MAbs. Electrophoretic separation of tumor tissue extracts followed by staining with these MAbs revealed that a component having an approximate molecular weight of 1,000,000 is the major site for the binding of MAbs, FH6, FH4, and KH1. The electrophoretic mobility of the antigenic molecule on polyacrylamide gels as shown by direct MAb bindings was slightly different from that of a major sialomucin revealed by wheat germ agglutinin in the same tissues. MAb FH6 binding to a high molecular weight component was eliminated by prior treatment of the glycoprotein with mild acid or sialidase to remove sialic acid. Simultaneously, binding of MAb SH2, specific for dimeric Lex antigen, to this component increased. An extract was prepared from a liver metastasis, and high molecular weight components were isolated by gel filtration and then fractionated by DEAE-cellulose ion exchange chromatography. A fraction eluted from DEAE-cellulose between 0.10-0.25 M sodium chloride contained most of the MAb FH6 reactivity, as shown by antibody affinity chromatography. These results support a hypothesis that high molecular weight glycoproteins produced by colorectal carcinoma tissues are heterogeneous with regard to their carbohydrate chains and their antigenic structures may change during tumor progression.

Topics: Adult; Aged; Antibodies, Monoclonal; Carbohydrate Sequence; Chromatography, Ion Exchange; Colonic Neoplasms; Female; Glycoproteins; Humans; Lewis X Antigen; Macromolecular Substances; Male; Middle Aged; Molecular Sequence Data; Molecular Weight; Mucins; Neoplasm Metastasis; Rectal Neoplasms; Regression Analysis; Sialic Acids

Colorectal carcinomas are composed of heterogeneous cell subpopulations which may be instrumental in conferring metastatic potential and therapeutic refractoriness to these tumours. To assess cellular heterogeneity, the expression has been examined of two oncodevelopmental antigens, carcinoembryonic antigen (CEA) and stage-specific embryonic antigen 1 (SSEA-1), by double immunofluorescence microscopy on 11 human colorectal carcinomas. Although both antigens were expressed in each tumour, their regional and cellular locations differed considerably. SSEA-1 expression was rarely expressed in poorly differentiated cancers but was enhanced with increasing degrees of differentiation. CEA expression was independent of histological differentiation. SSEA-1 was expressed with similar frequency in cell membranes, cytoplasm, and glandular contents regardless of degree of differentiation. Cytoplasmic staining with CEA however, was limited to more poorly differentiated tumours. In normal mucosa remote from the tumours and transitional mucosa adjacent to them, SSEA-1 stained only a few lower crypts whereas CEA stained a majority of both upper and lower crypts. Although biochemical studies have indicated that the SSEA-1 epitope may reside on CEA molecules, the fact that colon cancer tissues express these two antigens quite heterogeneously suggests differences in antigenic processing which may be dependent upon the degree of cellular differentiation.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antigen-Antibody Complex; Carcinoembryonic Antigen; Cell Transformation, Neoplastic; Colonic Neoplasms; Glycolipids; Humans; Intestinal Mucosa; Lewis X Antigen; Neoplasm Staging; Rectal Neoplasms; Reference Values

The expression of carbohydrate antigen 19-9 (CA 19-9) and stage-specific embryonic antigen 1 (SSEA-1) in various human colorectal epithelia was examined by an immunohistochemical method. In mucosa remote from the carcinoma, CA 19-9 was not expressed, whereas SSEA-1 was only faintly expressed in lower crypts in all cases. In mucosa adjacent to the carcinoma, CA 19-9 was weakly expressed in upper crypts in 20% of the cases, whereas SSEA-1 was expressed not only in lower crypts in all cases but also in upper crypts in 93.3% of the cases. In adenoma, CA 19-9 was expressed in 80.6% of the cases, and SSEA-1 was expressed in all cases. The expression of both antigens was to some extent related to the degree of cellular atypia. In focal carcinoma in adenoma, CA 19-9 was strongly and diffusely expressed in 50% of the cases, and SSEA-1 was strongly and diffusely expressed in all cases. In advanced carcinoma, CA 19-9 was homogeneously or heterogeneously expressed in 82.2% of the cases, and SSEA-1 was homogeneously or heterogeneously expressed in all cases, but lower intensity of SSEA-1 staining was associated with a decrease in the degree of carcinoma differentiation. These results show that the expression of both CA 19-9 and SSEA-1 changes along with neoplastic transformation and progression in the colon and rectum. Immunohistochemical studies of SSEA-1 in flat colorectal mucosa might be a useful approach for detecting foci with preneoplastic change in the general population, whereas those of SSEA-1 and CA 19-9 could be a useful method for detecting focal carcinoma in adenoma.

Topics: Adenoma; Antigens, Neoplasm; Antigens, Tumor-Associated, Carbohydrate; Carcinoma; Colon; Colonic Neoplasms; Glycolipids; Humans; Intestinal Mucosa; Lewis X Antigen; Rectal Neoplasms; Rectum

A monoclonal antibody defining the Lewis blood group determinant was used to immobilize antigen in sera of patients with adenocarcinoma of the gastrointestinal tract, and a second radiolabeled antibody, which defines a gastrointestinal cancer-associated antigen (GICA), was used to detect the immobilized antigen. With this approach, elevated antigen levels were found in 34 of 49 (69%) of sera from patients with advanced colorectal carcinoma as compared with 9 of 292 (3%) of sera from patients with non-malignant gastrointestinal diseases and of healthy donors. For early primary colorectal carcinoma, the combination of anti-Lewis and anti-GICA monoclonal antibodies was more sensitive in detecting GICA than using anti-GICA antibody alone. Double determinant radioimmunoassay revealed the glycolipid determinant lacto-N-fucopentaose (LNF) III circulating in colorectal carcinoma patients' sera. 53% of patients older than 65 years had elevated levels of the LNF III determinant compared to none of age-matched, apparently healthy donors or patients with benign gastrointestinal tract lesions, and 18% of patients with inflammatory gastrointestinal tract diseases. In younger patients, the differences were less marked. Our results suggest the potential usefulness of Lewis and LNF III determinants as markers for the detection of gastrointestinal tract malignancies.

Topics: Adult; Aged; Animals; Antibodies, Monoclonal; Antigens, Neoplasm; Colonic Neoplasms; Gastrointestinal Diseases; Gastrointestinal Neoplasms; Humans; Lewis Blood Group Antigens; Lewis X Antigen; Mice; Mice, Inbred BALB C; Middle Aged; Oligosaccharides; Rectal Neoplasms