lewis-y-antigen and Carcinoma-in-Situ

The cell-surface carbohydrate Lewis(y) antigen (blood group 8, BG8) has recently been investigated in bladder cancer, but its role in the differential diagnosis of flat urothelial lesions of the bladder has not yet been systematically evaluated.. 30 carcinoma in situ (CIS) and 30 non-CIS conditions of the bladder mucosa (four dysplasia and 26 reactive atypia according to consensus diagnoses) were comparatively assessed in terms of their Lewis(y) antigen staining profiles by two independent clinical pathologists.. Lewis(y) antigen expression differed significantly (p<0.001) between CIS (full thickness expression throughout the entire urothelium including the basal cell layer) and non-CIS conditions (patchy discontinuous expression restricted to individual cells scattered singly throughout the urothelial mucosa). The four dysplastic study cases showed Lewis(y) antigen expression more closely related to the staining profiles observed in most of the reactive urothelial atypia. κ statistics showed excellent inter-observer agreement between both raters in terms of Lewis(y) antigen staining evaluation (κ=0.9, p<0.001).. The data hint at the cell-surface carbohydrate Lewis(y) antigen as a so far neglected diagnostically useful marker to aid in the histological classification of conventionally equivocal flat urothelial lesions of the bladder in contemporary surgical pathology practice.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma in Situ; Diagnosis, Differential; Female; Humans; Hyperplasia; Immunohistochemistry; Lewis Blood Group Antigens; Male; Middle Aged; Observer Variation; Precancerous Conditions; Retrospective Studies; ROC Curve; Urinary Bladder; Urinary Bladder Neoplasms; Urothelium

We semiquantitatively analyzed expression of PCNA and LeY in seborrheic keratosis (SK), actinic keratosis (AK), Bowen's disease (BD), and squamous cell carcinoma (SCC), using immunocytochemically stained tissue sections. PCNA expression increased in a stepwise fashion from low levels in normal skin to higher expressions within SK, AK, BD, and SCC. The levels of LeY protein also increased in this order. The PCNA expression pattern shifted from expression limited to the basal and suprabasal cell layers (in normal skin and SK) to expression extending to the upper squamous and granular layers (in AK, BD, and SCC). On the other hand, the pattern of LeY expression shifted from the granular (in normal skin) to the upper squamous (in SK and AK) and suprabasal layers (in BD and SCC). These findings suggest that PCNA expression is related to the degree of cell proliferation and that LeY expression is related to the degree of differentiation or keratinization of tumor cells. In addition, PCNA and LeY show a reciprocal relationship in their expression.

Topics: Bowen's Disease; Carcinoma in Situ; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; Keratosis, Seborrheic; Lewis Blood Group Antigens; Proliferating Cell Nuclear Antigen; Skin Neoplasms