Immunologic indicators of prognosis in bladder cancer: the importance of cell surface antigens.

The loss of isoantigens on the surface of cells has been correlated with invasion in 89 patients with bladder cancer: 73 underwent cystectomy and 16 had stage A tumor and were followed. Tumors from these 89 patients were re-examined for the presence or absence of A, B and O (erythrocytic) isoantigens on the surface of neoplastic cells by the red cell adherence test. In 97% of the cystectomy patients with transitional carcinoma lacking superficial cellular antigens (red cell negative tumors) there was documented evidence of invasion and 71% of the patients with stage A, red cell negative tumors eventually had invasion. This high degree of correlation between the loss of cellular antigens and the presence of invasion lends credence to the usefulness of the specific red cell adherence test as an important adjunct in the decision for appropriate therapy of cancer of the bladder.