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

目的：本研究旨在探讨唾液酸和唾液酸刘易斯x在膀胱癌细胞中的表达与膀胱癌恶性进展的关系，寻找简便实用的肿瘤标志物。结果：1.膀胱肿瘤组织唾液酸含量（663.2 × 399.4mg/mg蛋白）高于肾癌、正常肾和正常尿路上皮组织（分别为110.4、181.5和73.3mg/mg蛋白）。高级别膀胱肿瘤组织的唾液酸刘易斯X值（1039 mg/mg蛋白和1468 mg/mg蛋白）高于肾癌、正常肾和低级别膀胱肿瘤组织（分别为653、664和507 mg/mg蛋白）。2.膀胱肿瘤患者尿中唾液酸的平均水平和中位数分别为10.6 × 3.4mg/dl和10 mg/dl。这些显著高于来自各种泌尿系统疾病（不包括膀胱癌）的显微镜蛋白的受试者尿液中唾液酸的相应值。以8 mg/dl为界值时，尿唾液酸诊断肺癌的敏感性为100%，特异性为81.8%，阳性预测值为67.7%，阴性预测值为100%。3. 7例膀胱肿瘤中6例抗Lewis X抗体阳性。尽管RT-PCR检测到Fuc-T III、V、VI和VII在所有膀胱肿瘤中的强扩增，但这些结果与肿瘤的组织学分级和唾液酸刘易斯X表达不一致。

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.