Publication: Comparison of different techniques for detection of Gal-GalNAc, an early marker of colonic neoplasia
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Date
1999
Authors
Said, I.T. ; Shamsuddin, A.M. ; Sherief, M.A. ; Taleb, S.G. ; Aref, W.F. ; Kumar, D.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The tumor marker, D-galactose-B[1-31-Nacetyl-
D-galactosamine (Gal-GalNAc, also known as Tantigen)
can be identified by a very simple galactose
oxidase-Schiff 's (GOS) reaction either on tissues or on
rectal mucus samples from patients with colorectal
neoplasms. Gal-GalNAc is expressed in the neoplastic
mucosa as well as the remote non-neoplastic mucosa. It
is, however, not expressed in colonic mucosa of normal
subjects. We studied the expression of Gal-GalNAc by
GOS reaction, lectin reactivity and immunocytochemistry
in 10 normal, 45 precancerous [5 Crohn's
disease, 15 ulcerative colitis (5 without dysplasia and 10
with dysplasia), 25 tubular adenomas], and 25
adenocarcinoma cases. Normal mucosa remote from
tubular adenoma and adenocarcinoma was also studied.
The GOS method was compared with reactivity of the
lectin jacalin and immunostaining with antibody to T
antigen (Anti-Tag Ab). GOS reaction was negative in all
of the 10 normal specimens. Of the 5 Crohn's disease
specimens, 2 were positive and 3 negative. In the 5
ulcerative colitis cases without dysplasia, positive
reaction was seen in 2 cases and negative in 3. Of the 10
cases of ulcerative colitis with dysplasia, 5 showed
positivity in dysplastic areas, and 3 of these were also
positive in remote non dysplastic mucosa. Twenty of 25
tubular adenomas yielded a positive reaction in the
adenoma, 14 of them showing positivity also in remote
mucosa; 3 cases showed a positive reaction only in
remote mucosa. Of the 25 adenocarcinomas, 21 showed
a positive reaction in the adenocarcinoma as well as the
remote mucosa. GOS reaction was intense in well
differentiated adenocarcinoma and weak in poorly
differentiated adenocarcinoma. Intense reaction was also
seen in the intracellular mucus of some aberrant crypts
and morphologically normal crypts remote from adenocarcinoma
and tubular adenoma. GOS reaction showed
an overall sensitivity of 75.7% and specificity of 100%
for cancer and precancerous lesions. Jacalin reactivity
was slightly more sensitive (84.3%) but less specific
Offprint requests to: Dr. A.M. Shamsuddin, Department of Pathology ,l0
S Pine Street, Baltimore, MD, USA 21201-1192. Fax: 410-706-8414
(80%) and Tag Ab reactivity even less sensitive (50%)
but as specific (100%) for neoplastic and dysplastic
mucosa. We conclude that the detection of the carbohydrate
moiety Gal-GalNAc varies with the technique
used. Compared to other techniques, GOS reaction is
extremely simple and has a high degree of sensitivity
and specificity. It can be used for detection of this tumor
marker in remote non-neoplastic mucosa of patients with
neoplasia or at risk of developing neoplasia. It, therefore,
could be used as a cost effective screening test in rectal
biopsy specimens of such patients.
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