The meaning of the measurement of oligosaccharide antigens and its regulatory factors as a tumor marker for malignant progression of bladder cancer

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Objective : The aim of study is to investigate the relation of expression of sialic acid and sialyl Lewis x in bladder cancer cells to malignant progression of the bladder cancer and to indicate simple and useful tumor markers. Results : 1. Sialic acid levels of the tissue of bladder tumors (663.2*399.4 mg/mg.protein) were higher than those of renal cancer, normal kidney and normal urothelium (110.4, 181.5 and 73.3 mg/mg.protein respectively). Sialyl Lewis X values of the tissue of high grade bladder tumors (1039 mg/mg.protein and 1468 mg/mg.protein) were higher than those of renal cancer, normal kidney and low grade bladder tumor (653, 664 and 507 mg/mg.protein respectively). 2. The mean levels and a median value of sialic acid in urine of the patients with bladder tumor was 10.6*3.4 mg/dl and 10 mg/dl respectively. Those were significantly higher than the respective values of sialic acid in urine of the subjects with microscopic protein derived from various urological diseases, excluding bladder cancer. When the cut-off level being set at 8 mg/dl, sialic acid in urine had a sensitivity of 100%, a specificity of 81.8%, a positive predictive value of 67.7% and a negative predictive value of 100%. 3.Immunohistological study with anti-Lewis X antibody revealed positive staining in 6 of 7 specimens of bladder tumor. Although strong amplification of Fuc-T III, V, VI and VII were detected by RT-PCR in all the bladder tumors, these results did not correspond to histological grade and sialyl Lewis X expression of the tumors.