Comparison of specific red-cell adherence and immunoperoxidase staining techniques for ABO(H) blood-group cell-surface antigens on superficial transitional cell carcinoma of the bladder.

The presence or absence of blood-group antigens have been used to predict the clinical course of patients with superficial transitional cell carcinoma of the bladder. Antigen loss has been associated with neoplastic change. The red-cell adherence test has been the most widely accepted method of antigen determination, but this technique has inherent weaknesses. Recently, the immunoperoxidase assay has been used to detect antigens on tumor cells. We compared 30 patients using the red-cell adherence and immunoperoxidase methods on adjacent microtome cut sections. The red-cell adherence and immunoperoxidase methods performed similarly (86%) when assessing antigen presence or absence. However, the immunoperoxidase method was clearly superior in: 1) specificity for antigens on tumor cells and normal internal controls; 2) localization of antigen; 3) demonstration of cellular morphology; 4) increased objectivity of analysis; 5) ease of reproducibility; and 6) cost effectiveness.