ISO ANTIGENS A , B AND H IN URINARY BLADDER LESIONS AND ITS ADJACENT MUCOSA
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Expression of blood group antigens A , B and H was studied in 6 cases with chronic cystitis , 31 cases with squamous cell carcinoma ( S.C.C. ) , 13 cases with transitional cell carcinoma ( T.C.C. ) , 3 cases with adenocarcinoma , 2 cases with undifferentiated carcinoma and 5 cases of normal urinary bladder epithelium as control - using the Tanta Medical Journal .942 immunoperoxidase staining via pe:oxidase antiperoxidase ( PAP ) technique . It was found that the areas of chronic cystitis retained A, B and H antigens similar to the control ( normal urinary bladder epithelium ) while in patients with S.C.C., 55% of the patients with grade I tumours , 82% with grade H and 89% with grade HI tumours had loss of cell surface antigens and 29% of the cases expressed H - antigens in the areas of S.C.C. In patients with T.C.C., 50% of the patients with grade I tumours, 75% with grade II and all patients with grade III tumours had loss of cell surface antigens and 38.5% of the cases demonstrated H - antigens in the areas of T.C.C. All cases of undifferentiated carcinoma had loss of cell surface antigens . In contrast , cases of adenocarcinoma showed loss of isoantigens in 2 cases of grade I and expressed them in grade II tumour. Sixty seven percent of the cases expressed H antigens in the areas of adenocarcinoma . The adjacent areas to carcinoma whether S.C.C. or T.C.C. were regaining the normal antigen and losing the H - antigen gradually as one goes from the micro - invasive area to areas of carcinoma in situ, dysplasia and back to normal epitheli- UM . This study suggests that expression of A, B and H . blood group isoantigens in the urinary bladder carcinoma ( S.C.C. or T.C.C. ) is correlated to the grade of tumour and tends to be lost as the histological Vol 22, June 30, 1994 943 grade increases . Patients with blood group 0 were more susceptible to loss of blood group isoantigens. Further studies are recommended to correlate between A , B & H isoantigens with the prognosis .