Dolichos biflorus agglutinin binding in hereditary bowel cancer.

Dolichos biflorus agglutinin (DBA) binds specifically to N-acetylgalactosamine (GalNAc), one of the 5 sugars contributing to the oligosaccharide component of human colorectal goblet cell mucin. DBA binds to goblet cells of the upper crypt and surface epithelium within the proximal colon and to the majority of goblet cells of the distal large bowel. DBA therefore serves as a marker of colorectal goblet cell differentiation with a distinct proximal to distal gradient effect. Previous reports indicate significant loss of DBA reactivity within morphologically normal colorectal mucosa derived from at-risk members of hereditary non-polyposis colorectal cancer (HNPCC) families. This finding could not be confirmed in the present study. Reduced binding was a relatively consistent finding in transitional mucosa, hyperplastic polyps and carcinoma, with adenomas displaying a more varied pattern of loss. Reduced binding by DBA may be explained by several mechanisms and may not necessarily reflect loss of GalNAc. The concept that lectins can be used to identify stepwise changes that occur during neoplastic evolution should not be accepted uncritically.