Ongaro G, Issi M, Gallo T, Garbeglio A, Ranieri A, Dalla Palma P
Quad Sclavo Diagn. 1983 Jun;19(2):242-61.
The isoantigens A, B, and H, identical with those present in erythrocytes, are also present in epithelial cells of some normal tissues, included the transitional epithelium of the urinary bladder. The cell surface ABH antigens can be detected with the specific erythrocyte adherence method (SEA), but could not be detected when carcinoma developed in this tissue: with rare exceptions, the loss of demonstrable antigens paralleled morphological anaplasia. We studied retrospectively by SEA test 51 specimens of urinary bladder, including 36 primary transitional cell carcinomas at the time of initial biopsy, and 15 controls. The SEA reaction was strongly positive in normal bladder epithelium, in vascular endothelium and in erythrocytes already present in sections, while was negative in connective tissue. 21 were classified as grade 0 (papilloma): in 19 of them the ABH antigens were fully or partially preserved, and the follow up from 5 to 15 years demonstrated no recurrences; the other 2 patients with negative SEA recurred locally. The only one graded as I, with strongly positive SEA, had not recurred in at least 6 years, 5 were classified as grade II; in 2 of graded as III, the SEA reaction was weakly positive in 3, while in remaining 6 the antigens were absent. The usefulness of the detection of ABH antigens as a prognostic tool in low grade and stage bladder carcinomas is confirmed by our data establishing the correlation of antigens deletion with subsequent clinical behavior. An alteration of blood group substance synthesis occurs in malignant epithelium, but it is not known whether it causes or results from malignant changes. The SEA method resulted highly sensitive and specific; however, the test is cumbersome and time-consuming, requires special expertise and shows some limitations, particularly the frequency of the occurrence of false-negative or weakly positive results in blood group O patients.
与红细胞中存在的同种抗原A、B和H相同，也存在于一些正常组织的上皮细胞中，包括膀胱的移行上皮。细胞表面ABH抗原可用特异性红细胞黏附法（SEA）检测，但当该组织发生癌变时则无法检测到：极少数情况除外，可检测抗原的丧失与形态学的退行发育平行。我们通过SEA试验对51份膀胱标本进行了回顾性研究，其中包括36例初次活检时的原发性移行细胞癌标本以及15份对照标本。SEA反应在正常膀胱上皮、血管内皮以及切片中已有的红细胞中呈强阳性，而在结缔组织中呈阴性。21例被分类为0级（乳头状瘤）：其中19例ABH抗原完全或部分保留，5至15年的随访显示无复发；另外2例SEA阴性的患者出现了局部复发。唯一1例被分类为I级且SEA呈强阳性的患者至少6年未复发，5例被分类为II级；在2例被分类为III级的患者中，3例SEA反应呈弱阳性，而其余6例抗原缺失。我们的数据证实了ABH抗原检测作为低级别和低分期膀胱癌预后工具的有用性，确立了抗原缺失与后续临床行为的相关性。恶性上皮中发生了血型物质合成的改变，但尚不清楚这是由恶性变化引起还是导致了恶性变化。SEA方法具有高度敏感性和特异性；然而，该检测繁琐且耗时，需要专业知识，并且存在一些局限性，特别是在O血型患者中出现假阴性或弱阳性结果的频率较高。
