Regional differences in normal and cancer-associated glycoconjugates of the human colon.

Because inherent regional differences in colonic epithelium may determine the biologic behavior of tumors originating from different sites, and inasmuch as colonic epithelial cells secrete mucins that may reflect the state of cell differentiation, colonic goblet cell mucin was analyzed with the use of fluorescein isothiocyanate-conjugated lectins and fluorescence microscopy in normal fetal and adult mucosa and in cancers of the proximal and distal colon. In the adult proximal colon only the goblet cell mucin in the upper portion of the crypts was specifically labeled by the lectin Dolichos biflorus agglutinin (DBA), whereas this gradient was progressively lost distally; mucin in the upper and lower crypts of the sigmoid colon and rectum bound the label uniformly. In fetuses less than 22 weeks of age, DBA bound only to mucin in the crypts of the distal colon. Seven of 12 (58%) cancers originating from the proximal colon bound DBA, whereas only 2 of 23 (9%) from the distal colon bound this lectin (P less than .005). Logistic regression analysis suggested that this difference may reflect the occurrence of larger tumors in the proximal colon. Regional differences in the binding of Ulex europaeus agglutinin (UEA-I) to nonneoplastic mucosa was similar to that found by others; predominant binding occurred in the proximal colon in the adult. No difference was noted for UEA-I binding to tumors of the proximal (8 of 12; 66.6%) versus distal (11 of 23; 48%) colon (P = .48). These findings may reflect regional differences in normal and tumor-related carbohydrate structures in mucin of the human colon.