Immunocytology of the Lewis X Antigen in Patients with Bladder Tumor

Nam, Ung Chul; Lee, Sun Ju; Lim, Sung Jig; Lee, Juhie; Kim, Jin Il

Abstract

PURPOSE: To improve low sensitivity of urinary cytology in diagnosis and surveillance of bladder cancer, we performed a study using the Lewis X immunocytology with the murine BG-7 monoclonal anti-Lewis X immunoglobulin M antibody while comparing it with conventional urinary cytology. MATERIALS AND METHODS: Barbotage bladder washings were performed in 36 patients who were diagnosed as having bladder tumor after cystoscopy. The specimens were divided into conventional urinary cytology and immunocytochemical examinations. The cytologic examination was done according to Papanicolau. Indirect immunoperoxidase staining of urine samples was done using the murine BG-7 monoclonal antibody against the Lewis X antigen. Biopsies were obtained in all cases via transurethral resection. The results were analysed according to the tumor stage and grade. RESULTS: Of the 36 patients, 33 patients were diagnosed with transitional cell carcinoma, 1 with inverted papilloma, and 2 with chronic inflammation. Immunocytology showed positive results in 25 of the 33 patients, corresponding to a sensitivity of 75.8% while conventional cytology showed a sensitivity of 45.5%. This discrepancy was vivid in the cases of low grade transitional cell carcinoma. The sensitivities of conventional cytology were 23% in grade I and 50% in grade II, while those of immunocytology were 50% in grade I and 100% in grade II. CONCLUSIONS: Our data show that Lewis X immunocytology using the murine BG-7 monoclonal anti-Lewis X antibody can improve the sensitivity of noninvasive detection of transitional cell carcinoma of the bladder, especially in low grade tumor.