Monoclonal antibodies to detect A, B and H blood group isoantigens in superficial transitional cell carcinoma of the bladder: a means of predicting invasive recurrences.

Abstract

Monoclonal antibodies to A, B and H blood group isoantigens (BGI) have been used in an indirect immunoperoxidase technique to study the expression of BGI in both normal and malignant transitional epithelium in patients of all blood groups. BGI was detectable in all 15 biopsies of normal transitional epithelium and in 28 of 50 (56%) stage pTa and pTl transitional cell carcinomas of the bladder (TCCB). In the tumours failing to express BGI there was a 55% invasive recurrence rate at 5 years compared with 14% in those tumours expressing BGI. The difference was significant at the P less than 0.01 level. The recent availability of a monoclonal antibody to H isoantigen expressed in group O patients, in addition to monoclonal anti A and anti B, has made possible the inclusion of patients of all blood groups into a study using a standard immunoperoxidase technique without the need for specially processed biopsy material. The advantages of this technique compared with the earlier methods are discussed with reference to its possible role in identifying those patients at highest risk of developing invasive recurrence of their tumour.