The A,B and H antigen states of epithelial cells from 50 patients with laryngeal lesions and their adjacent mucosa have been assessed using peroxidase anti-peroxidase (PAP) technique. Inflammatory polyps and primary papillomata expressed the A,B antigens while recurrent papillomata showed either complete or patchy loss with occasional presence of H antigen. The adjacenumucosa expressed normally the antigen except in few; cases of recurrent irapilloma where the antigen was expressed weakly.
Grade III dysplasia showed either weak expression or loss of isoantigen; expression of H antigen was sometimes demonstrated.
Carcinoma in-situ showed loss of isoantigens and expression of H antigen in 50% of the esses. The other 50% expressed the A,B antigen weakly.
Results obtained from areas of microinvasive and invasive carcinoma showed loss of A,B isoantigens in 87.5% of the cases; appearance of H antigen was seen in 50% of the cases. The adjacent areas were regaining the normal antigen and loosing the H one gradually as we go from the microinvasive to areas of carcinoma in-situ, dysplasia and back to the normal epithelium. However two cases of carcinoma with keratinized differentiated pattern expressed the antigen strongly.
In conclusion, loss ul ihe normally present blood group antigen or the appearance of its pre-curser H antigen should be taken as a histological evidence of potentially neoplastic epithelium even if it looks historically benign. The question is could this phenomena be used as a land- mark for good surgical safety margin?
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