Paraffin-embedded tissue sections of primary
tumors and
lymph node metastases of 80
breast cancer patients were tested for the expression of Thomsen-Friedenreich (TF)
antigens with the aid of a monoclonal
IgM antibody (49H8) highly specific for
phenyl-beta-galactoside. TF
antigens were not expressed in 16 different normal tissues with the exception of some structures in the kidney. In
tumor cells, two types of
antigen expression were found; namely, cryptic and exposed. From stage T1/No to stages T2-4/N1,2 the number of cases expressing high amounts of TF
antigens increased from 9% (2/22) to 22% (4/18) while the percentage of patients with low intensity of antibody binding was reduced from 59% (13/22) to 39% (7/18). The total amount of TF-positive primary
tumors at stages T2-4/No increased from 42% (8/19) to 69% (18/26) when lymph nodes were infiltrated (T2-4/N1,2). At this stage 80% (21/26) of the patients with lymph node infiltration carried TF
antigens in the nodes. The distribution of
antigens was heterogeneous among the
tumor cells and was expressed mainly in an apical or
luminal position. The increased expression of
antigens was attributed to exposed TF
antigens, while cryptic
antigens remained constant. When primary
tumors expressed exposed TF
antigens, the corresponding lymph nodes also contained exposed
antigen. The same was true for the cryptic
antigen. The data demonstrate an increase in the intensity of
TF antigen expression during
tumor progression and a spread of TF-positive
tumor cells into the axillary lymph nodes with an increasing number of
breast cancer patients being TF-positive at this stage.