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We have earlier prepared a pancreatic cancer-associated mucin, whose altered carbohydrate structure was recognized by Vicia villosa (VVA), Bauhinia purpurea (BPA), and peanut (PNA) lectins and which was found preferentially in the sera of patients with pancreatic or gastric cancer. Cancer-associated structures of the sugar chain on serum antigen may reflect those occurring in malignant tissues. Accordingly, we investigated the tissue distribution of carbohydrate structures reactive to these lectins by using lectin histochemistry in pancreatic cancer, gastric cancer, and colonic cancer tissue specimens and in their normal counterparts. VVA showed a higher affinity for pancreatic cancer (77.5%), gastric cancer (89%), and colonic cancer (87%) cells than for the cells of their normal counterparts, whose affinity was 0%, 41.7%, and 36.4%, respectively. PNA showed a higher affinity for pancreatic (70%) and colonic cancer cells (86.5%). BPA failed to show significant binding differences between neoplastic and normal cells in any of the pancreatic, gastric, or colonic tissue specimens. It did, however, bind to intraductal contents in most of the pancreatic cancer tissues but bound to intraductal contents in only a few chronic pancreatitis and normal pancreatic tissues. VVA and PNA did not bind to intraductal contents in any of the normal, chronic pancreatitis, or pancreatic cancer tissues. These results imply that, among the lectins used so far, VVA has the highest affinity for neoplastic cells, and it may provide a supplement for use in the pathologic diagnosis of malignant diseases. Lectin-binding glycoproteins presenting in cancer tissues may be released into the bloodstream, as confirmed by the identification of BPA- and VVA-reactive antigens in the sera of cancer patients, including those with pancreatic cancer, in our previous study.

In our previous study, two antigens associated with pancreatic cancer were prepared from ascites of the patients by using a newly developed affinity chromatography technique; one expressed CA19-9, CA50, Span-1, sialyl SSEA-1, and Dupan-2. This report describes the other part of the antigens, which was scarcely found in normal sera. This antigen was a glycoprotein with a high molecular weight of 1,000,000 in its native state, estimated by size exclusion chromatography on Sephacryl S400. After sodium dodecyl sulfate polyacrylamide gel electrophoresis and blotting analysis, the antigenic activity was observed on the 200-Kd band, and monoclonal antibody of CA50 showed intense reactivity to it. By means of an enzyme immunoassay, CA19-9 determinant was also recognized on it to a lesser extent, although sialyl SSEA-1 and Dupan-2 determinants were scarcely observed. From these observations, the present antigen was considered to be a serum glycoprotein carrying type-1 polylactosamine determinant and differs from previously reported glycoprotein carrying CA19-9 in its insolubility in perchloric acid solution because of its lesser degree of glycosilation. Serum levels of the antigen measured by enzyme-linked immunosorbent assay demonstrated that highly positive rates were observed in 78% of pancreatic cancers, 82% of biliary tract cancers, and 96% of hepatocellular carcinomas.

We have previously described the purification and partial characterization of a new pancreatic cancer-| associated antigen, a pancreatic cancer-associated mucin expressing CA19-9, CA50, Span-1, sialyl SSEA-1, and Dupan-2. This study describes the clinical evaluation of various assay systems for this antigen which depend on measuring respective serum levels. Elevated levels of antigen were detected in the sera from both patients with malignant and non-malignant diseases. However, elevated serum levels of CA19-9 and Lewis" and Lewisb epitopes on moieties were restricted to pancreatic and biliary tract cancers, although adequate sensitivity was not attained. Coordinate evaluation of these three markers improved the sensitivity to some extent without loss of specificity for the diagnosis of pancreatic and biliary tract cancers, because of the heterogeneity of the coexpression of these epitopes. We developed additional assay systems with a combination of this antigen and two lectins (Bauhinia purpurea (BPA) and Vicia villosa (VVA)). Elevated levels of BPA- and WA-reactive antigens were detected in 41% and 31%, respectively, of pancreatic cancer sera samples. Few patients with chronic pancreatitis had an elevated serum level of either antigen, and higher elevated levels of these markers were restricted to the sera of patients with malignancies. Our results suggest that this antigen is found in the sera of patients with various conditions and in the sera of normal subjects but that antigens bearing CA19-9 or Lewis3 or Lewisb epitopes and an altered carbohydrate structure recognized by BPA and WA lectins are preferentially present in the sera of patients with pancreatic and other malignancies.