Cell surface A, B, or O(H) blood group antigens as an indicator of malignant potential in stage A bladder carcinoma.

The major blood group antigens A, B or O(H) are present on normal bladder epithelium. The presence or absence of these antigens on the cell surface of bladder tumors has been determined in a retrospective longitudinal study using biopsy material from 322 patients who fit the following criteria: 1) the patient presented initially with a superficial bladder tumor, 2) the patient had followup examination for at least 5 years or until evidence of tumor invasion of bladder muscle and 3) the paraffin-embedded tumor specimens were still available. Of 80 patients with stage A tumors that subsequently became invasive 71 (88 per cent) showed deletion of A, B or H antigens from the original superficial tumor. On the other hand, of 146 patients who had no recurrence of superficial tumor for at least 5 years 127 (87 per cent) retained A, B or H antigens. Of 96 patients who had 1 or more superficial recurrences 87 (90 per cent) retained antigens on the initial and subsequent tumors. Analysis of transitional cell surface antigens should help in the identification of those patients with superficial disease who are at greatest risk for invasive bladder cancer.