Korean J Blood Transfus.  2000 Dec;11(2):115-123.

Influence of Lewis phenotype and genotype on serum CA19-9 and DUPAN-2 level in gastric cancer patients

  • 1Korean Red Cross Seoul Dongbu Red Cross Blood Center.
  • 2Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea.


Lewis antigens are not intrinsic to red cells, but are adsorbed from plasma to the red cell membranes. It is known that Lewis blood antigen is altered according to pregnancy, alcoholic cirrhosis, pancreatitis, and malignant tumor. The aim of this study was to investigate the alteration of RBC Lewis antigen expression and the correlation of Lewis genotype with serum CA19-9 and DUPAN-2 levels in gastric cancer patients.
Fifty-seven gastric cancer patients and forty five healthy controls were examined and compared in regard to Lewis blood phenotype and genotype. Serum levels of sialyl Lea(CA19-9) and sialyl Lea-b-(DUPAN-2) were measured by EIA to evaluate the relationshop between Le and Se genotype. RESLUTS: In heathy controls, the percentage of blood phenotype of Le(a+b-), Le(a-b+), and Le(a-b-) were 15.6%, 71.1%, and 13.3%, respectively; and in gastric cancer patients, 15.8%, 57.9%, and 26.3%, respectively. Le(a-b-) phenotype was more frequent in gastric cancer patients than in healthy controls. In gastric cancer patients, the percentage of Lewis genotype of (Le/-, se/se), (Le/-, Se/-), and (le/le, -/-) were 21.1%, 68.4%, and 10.5%, respectively. The Lewis gene frequency was not different between gastric cancer patients (Le 0.623, le 0.377) and healthy controls (Le 0.635, le 0.365). Many of Le gene negative patients (le/le) with gastric cancer exhibited high positive DUPAN-2 levels in serum, and many of Le gene positive patients showed high CA19-9 levels.
This result showed that a loss of Lewis antigen in red blood cell in gastric cancer patients occurs during the adsorption of Lewis antigen to the red blood cell rather than the alteration of gene structure. And in using CA19-9 or DUPAN-2 as a tumor marker, a test of Lewis blood phenotype should be performed.


gastric cancer; Lewis antigen; secretor gene; CA19-9; DUPAN-2
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