Expression of Lewisa, Lewisb, Lewisx, Lewisy, siayl-Lewisa, and sialyl-Lewisx blood group antigens in human gastric carcinoma and in normal gastric tissue.

A panel of 6 mouse monoclonal antibodies detecting blood group antigens of the Lewis systems and their sialylated derivatives have been used to define the immunoanatomic distribution of these antigenic structures within the normal human gastric mucosa and in gastric cancer tissues. The reagents employed detect the following blood group specificities: Lewisa, Lewisb, Lewisx, Lewisy, sialylated Lewisa, and sialylated Lewisx. We have analyzed the presence of these antigens in histologically normal gastric mucosa and in gastric carcinoma from 61 patients by the immunoperoxidase method. In addition, we simultaneously examined the blood group and secretor status in 31 of the 61 individuals studied. Immunohistochemical analysis revealed that these antigenic systems are differentially expressed in cell types and cell layers of the normal gastric epithelium. Major differences were observed in surface epithelia and in deep glands including Brenner's gland of the gastroduodenal junction, mainly in the pronounced expression of Lewisa and Lewisb antigens in the former and the expression of Lewisx and Lewisy in the latter. In secretor individuals, Lewisb was the dominant antigen in the surface epithelium, and in nonsecretors, Lewisa was observed in the surface epithelium, Lewisx and Lewisy were both detected in the deep glands and in Brenner's glands regardless of the secretor status. The expression of sialylated derivatives in normal gastric tissues was considerably reduced but was consistent with the expression of their precursors in normal gastric epithelium. In gastric cancers, more pronounced expression of Lewisa and sialylated Lewisa was observed in secretor individuals and acted as a tumor-associated antigen. Comparison of the plasma level of sialylated Lewisa and its tissue expression demonstrated that the shedding of the antigen into interstitial stroma correlated with the detection of the antigen in serum. These studies confirmed the importance of blood group antigens as normal differentiation antigens. Examination of secretor status clarified the mechanism of Lewisa and Lewisb antigen expression in gastric surface epithelium. Alterations in the expression of these antigens and an increase of sialylated derivatives in gastric cancers demonstrated that these blood group antigens are useful tools for the analysis of histogenesis and organogenesis in the stomach and its neoplastic and nonneoplastic diseases.