Differential expression of the Lewis Y antigen defined by monoclonal antibody C14/1/46/10 in colonic polyps.

The expression of Le(y) (Lewis(y) Hapten), a difucosylated type 2 blood group-related antigen, in colorectal lesions was studied by using the monoclonal antibody C14. In normal colonic mucosa, strong staining has been observed in the terminal ileum, cecum, and ascending colon with minimal staining in the rest of the colon and rectum. Eighty-three percent of adenomas expressed Le(y), with 70% showing an increased expression of Le(y) compared with normal tissue. Only 25% of metaplastic (nonneoplastic) polyps showed an increased expression of Le(y). The expression of Le(y) in adenomas was correlated with both size and degree of epithelial dysplasia of the adenomas and also showed an association with histologic type. No correlation was found with the location and morphology of the adenomas. The most strongly related parameter was the degree of dysplasia. All adenomas with severe dysplasia showed increased expression of Le(y), with 83% showing marked expression. This finding was irrespective of their size or type. Adenomas which did not exhibit severe dysplasia showed increased expression in 66% of cases, but only 18% showed marked expression. These findings show that the expression of Le(y) in colorectal lesions is associated with features related to malignant potential. Le(y) expression may provide useful prognostic information in the assessment of colorectal polyps.