BLOOD-GROUP ANTIGENS IN BARRETTS-ESOPHAGUS AND ASSOCIATED ADENOCARCINOMAS

A panel of monoclonal antibodies (MoAbs) against BGAg A, B, and H and Lewis a, b, X, and Y (Le a, Le b, X, Y) was used to characterize and e valuate the blood group antigens (BGAg) immunohistochemistry in Barret t's esophagus (BE) and associated adenocarcinomas (ACA). Thirteen case s of ACA arising in metaplastic columnar epithelium of the distal esop hagus were reviewed (12 men; 1 woman; mean age: 59). Twelve cases had juxtaposed BE of different types with low-grade dysplasia in five and high-grade dysplasia in three. ACAs were classified as well differenti ated (one case), moderately differentiated (three cases), and poorly d ifferentiated (four cases). Five cases had mixed features. Loss of BGA g H was recorded in four ACA and in one adjacent BE. Loss of BGAg B wa s noted in three ACAs, but in only one case in the adjacent BE. Incomp atible expression of BGAg A and B was present in one case each. Anomal ous expression of Le a was seen in seven ACAs and adjacent BE. Loss of Le b was noted in six ACAs. Deletion of X was seen in four ACAs and i n BE. Loss of Y was present in the only nonsecretor patient. We conclu de that significant alterations of BGAg occur in BE and in associated ACAs. Recognition of these antigenic alterations warrants further inve stigation to define a role for BGAg immunohistochemistry in the survei llance of BE patients at risk of developing ACA.