ABO(H) isoantigens in bladder tumours : a new technique of quantitative analysis

Srinivas, V.(Varadarchary) (1982) ABO(H) isoantigens in bladder tumours : a new technique of quantitative analysis. Masters thesis, Memorial University of Newfoundland.

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Abstract

Bladder tumours are the second most common urological malignancy seen and twenty-five percent of all superficial tumours ultimately become invasive. -- The Specific Red Cell Adherence Test (SRCA) appears most promising with a potential to predict which superficial bladder tumour(s) will ultimately become invasive. -- The major drawbacks of the test in its present format are: 1. Inability to quantitate the test. 2. Variability of antigen expression in tissue sections. 3. Weak reaction in blod group ‘O’ patients. -- The objectives of this research project were: 1. To develop a new technique for quantitative analysis of ABO(H) isoantigens. 2. To improve the sensitivity of the test in blood group ‘O’ patients. -- The project was carried out in three phases: Phase 1: A new technique of obtaining viable single transitional cell suspensions from bladder biopsies with preservation of ABO(H) isoantigens was developed. Toluidine blue was used to confirm the presence of transitional cells and trypan blue stain to determine the viability and cell count. Cell separation was carried out successfully in 20 cases. Phase 2: A modified SRCA test with final staining procedure was developed to quantitatively measure the ABO(H) isoantigens in the single cell suspension. Bombay blood which contains a high titre of anti H antibodies was used successfully in blood group ‘O’ patients. Phase 3: A double blind clinical study was carried out in a total of 15 patients; 8 with normal bladder and 7 with bladder tumour. The biopsies were subjected to cell separation and quantitative analysis as worked out in phases 1 and 2. -- In the 8 patients with normal bladder, the mean antigen positive cell count was 88% and in the 7 patients with bladder tumour, the mean antigen positive cell count was 33%. The mean antigen positive counts between these two groups were significantly different at the P < .001 level. -- A new technique for quantitative analysis of ABO(H) isoantigens in bladder tumours has been developed and this should help in standardizing the test and making it applicable in different prospective clinical trials.

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