Frequency and mechanism of Lewis antigen expression in human urinary bladder and colon carcinoma patients.

Changes in the expression of Lewis antigens have been associated with cancer diseases, and recent results have pointed at a possible increased risk of cancer development among Lewis negative patients. The frequency of the erythrocyte Lewis phenotypes Le(a- b+), Le(a+ b-) and Le(a- b-) was analysed in patients suffering from urinary bladder cancer (82), colon cancer (21), and benign urological diseases (45). An increased frequency of Lewis negative individuals was found among colon cancer patients (P less than 0.004) and bladder cancer patients (P = 0.05). The Lewis negative phenotype was shown to be associated with unfavourable disease parameters: invasion (P less than 0.02) and high grade of atypia (P less than 0.01) in bladder cancer patients, and high Dukes stage (P less than 0.05) in colon cancer patients. alpha 1-4fucosyltransferase activity (Lewis transferase) was shown to be present in saliva from four out of eight erythrocyte Lewis negative cancer patients, indicating that some patients with advanced cancer disease may have converted from a Lewis positive to a Lewis negative phenotype.