ISPUB.com / IJPA/13/1/5982 Internet Scientific Publications The Internet Journal of Pathology Volume 13 Number 1 Original Article Relationship Between Various Cancers And ABO Blood Groups -- Northern India Experience K Akhtar, G Mehdi, R Sherwani, L Sofi Keywords abo blood group, cancer, incidence Citation K Akhtar, G Mehdi, R Sherwani, L Sofi. Relationship Between Various Cancers And ABO Blood Groups -- A Northern India Experience. The Internet Journal of Pathology. 2010 Volume 13 Number 1. Abstract Research Question: Incidence of ABO blood group in different cancers in Northern IndiaObjectives: To find out the incidence of ABO blood group in different cancers in Western Uttar Pradesh, so as to assess the utility of ABO blood group as a preclinical marker. Design: The study was conducted on 2640 histologically proven cancer patients attending the Blood Bank, Department of Pathology, JN Medical College, AMU, Aligarh during the period 2000-2007 for requisition of blood transfusion. ABO blood grouping was performed by the tube method in all the cancer patients. The age, sex, ABO blood type and pathological status of all the patients were collected. The control sample was collected from the healthy blood donors. Results: Among 2640 cancer patients, 1168 were males and 1472 female. When all cancers were taken together, the highest frequency of blood group B (40.5%), followed by A (34.2%), O (16.0%) and AB (9.3%) was seen. The frequency of A group was significantly higher and O group was significantly lower in cancer patients as compared to controls. A high incidence of blood group B (37.5%) followed by A (35%) was seen in oral cancers. Among gastrointestinal (GIT) cancer, a high frequency of blood group B (40%), followed by O (26.7%) was noted. The incidence of A blood group was significantly higher in breast cancer and lung cancer patients, 42.4% and 50.0% respectively. Conclusion: Racial and ethnic distribution of blood groups is an important factor for predicting cancer risk and the identification of genetic and environmental factors among racial and ethnic groups should offer some insights into an observed epidemiological data and opportunities to better understand the control and development of cancer. Introduction The ABO blood type, an easily accessible factor in patients' genetic make up, has been associated with many diseases, though the explanation for the association with ABO blood groups and some disease is still unclear. Since the first report showing an association between blood group A and gastric cancer1, numerous other reports have documented a relation between susceptibility to cancer and blood group. High incidence of blood group A in various cancers, including neurologic tumors, salivary gland, colon, ovary, kidney and cervix,2 and consistent relation to O blood group in skin and melanoma3 have been reported. ABO blood group genes are mapped at 9 q 34.2 region in which genetic alteration is common in many cancers. A correlation of blood group antigen expression in tumor with metastasis and prognosis has been reported for various human malignancies, such as colon, breast and prostate cancer as the blood group carbohydrates expressed on cell surface of metastatic cancer cells function as cell adhesion molecules4. The ABO blood group distribution varies in different geographical, ethnic and socio-economic groups5. The blood group frequency in north India is B > O > A > AB6. The present study is an attempt to correlate ABO blood group frequency with preponderance of various cancers in western Uttar Pradesh, to assess the utility of ABO blood group as a preclinical marker. Material And Methods The present study was undertaken on 2640 histologically proven cancer patients in the Blood Bank, Department of Pathology, JN Medical College, AMU, Aligarh. The data of age, sex, ABO blood type and pathological status of cancer patients, during the period 2000-2007 attending the Blood Bank with requisition for transfusion were collected. The control sample was collected from the healthy blood donors. ABO blood grouping was performed by the tube method in all the cancer patients. Results Our study comprised 2640 cancer patients, with 1168 males and 1472 females (M: F :: 0.79: 1). The 2640 healthy controls included 1857 males and 783 females. When all cancers were taken together, the highest frequency of blood group B (40.5%), followed blood group A (34.2%), O (16.0%) and AB (9.3%) was seen in cancer patients. In control samples, high frequency of blood group B (40.5%), followed by O (29.5%), A (18.6%) and AB (11.4%) was noted. The frequency of A group was significantly higher and O group was significantly lower in cancer patients as compared to controls. In assessing the different types of cancers, among oral cavity cancers, high incidence of blood group B (37.5%), followed by group A (35%), O (20%) and AB (7.5%) was seen. Amongst gastrointestinal (GIT) cancers, a high frequency of blood group B (40%), followed by group O (26.7%), group A (23.3%) and AB (10%) was reported by us. Cervical cancer patients showed a preponderance of blood group B (37.9%), followed by group A (27.6%), AB (20.7%) and O (13.8%). The incidence of A blood group was significantly higher in breast and lung cancer patients (Table I). Figure 1 Table I: Blood group distribution in cancer patients and controls Discussion In cancer patients, the incidence of A group was higher in breast, lung, kidney and bladder cancers, though when all cancers were taken together, the incidence of B blood group was highest, followed by A group, whereas in controls, B and O groups were in higher frequency. There are contradictory reports available about the association of blood group with breast cancer. Jayant K7 reported no relation of breast cancer to any blood group whereas Surekha et al8 have reported a high incidence of breast cancer in blood group B individuals. But an increased rate of blood type A as compared to controls have been reported in breast cancer patients.9 A higher frequency of blood group B was seen in gastrointestinal tract and gall bladder cancers, 40% and 50% respectively in our study. Quite similarly Vioque and Walker10 have reported a strong association of gall bladder and bile duct cancers with B blood group. But Pandey et al11 have shown an increased frequency of carcinoma of the gall bladder in blood group A. Several authors have reported a high incidence of gastrointestinal cancers in blood group A patients1,12. The increased risk of development of gastrointestrial cancers in patients with blood group A has been explained by the expression of Forssman antigen in these cancers, which is structurally similar to the blood group antigen A. Because of this similarity, antibodies to A probably attack precancerous and cancerous cells expressing this antigen. Since people with blood group A lack antibodies to A so they are more prone to develop these carcinomas2. Our study revealed a high incidence of lung carcinoma in blood group A patients (50%). Quite similarly Loddenkemper et al13 have reported a significantly higher incidence of lung cancers in A blood group patients, with a peak in young patients not older than 50 years. A higher incidence of cancer of the cervix and ovary, 37.9% and 52.5% respectively, was seen in blood group B patients in our study; a finding similar to Kamlesh G et al4 who reported 57.1% of genitourinary cancers in blood group B individuals. Though the influence of blood group types on development of brain tumors is unclear, since there are conflicting reports from surveys regarding the distribution of ABO blood groups and primary intracranial neoplasms; the present study on 112 central nervous system tumors, revealed a significantly higher association of these tumors with blood group B patients, 56.2% but Mehrazin M14 in their study on ABO blood group frequency and brain tumors found no significant differences between types of intracranial tumors and frequencies of four major blood groups. Conclusion It appears that different blood groups are associated with different manifestations of the disease. From this correlation of blood groups and various cancers, it follows that there is an inherited element in the susceptibility or protection against different types of cancers; and the racial and ethnic distribution of blood groups is an important factor for predicting the cancer risk. The identification of genetic and environmental factors among racial and ethnic groups should offer some insights into the observed epidemiological data and advance opportunities to better understand the control and development of cancer. References 1. Acid I, Bentall H, Fraser RA: A relationship between cancer of the stomach and ABO blood group. Br Med J 1953; 1: 799-801. 2. Henderson J, Seagrott V, Goldacre M: Ovarian cancer and ABO blood groups. J Epidemiol. Comm. Hlth. 1993; 47: 287-289. 3. Karakousis C, Evlongmenos E, Sun O: Blood groups and malignant melanoma. J Surg Oncol. 1986; 33: 24-26. 4. Kamlesh G, Hardeep P, Harpreet K, Vasudha S: ABO blood groups in gastrointestinal tract (GIT) and breast carcinoma patients. Anthropologist. 2005; 7 (3): 189-192. 5. Beardmore JA, Karimi F, Booshehei K: ABO genes are differently distributed in socio-economic groups in England. Nature 1983; 303: 522-524. 6. Bhasin MK, Walter H, Danker HH: The distribution of genetical, morphological and behavioral traits among the peoples on Indian region. Kamla-Raj Publishers: New Delhi, 1992. 51-55. 7. Jayant K: Relationship of ABO blood group to certain types of cancer common in Western India. Ind J Cancer 1971; 8: 185-188. 8. Surekha D, Shrinivasan A, Sailaja K, Rao D: Association of esterase D and ABO blood group in breast cancer. In: Trends in Human Genetics, Biotechnology and Bioinformatics: Next 5 years. 29th Annual conference of Indian Society of Human Genetics, Bangalore. 2004; 122-123. 9. Anderson DE and Haas C: Blood type A and familial breast cancer. Cancer 1984; 54: 1845-49. 10. Vioque I, and Walker AM: Gall bladder cancer and ABO blood types: a study of cases and controls. Med Clin 1991; 96: 761-764. 11. Pandey M, Gautam A, Shukla VK: ABO and Rh blood groups in patients with cholelithiasis and carcinoma of the gall bladder. Ind J Surg 2001; 42: 112-115. 12. Itzkowitz SH: Blood groups related carbohydrate antigen expression in malignant and premalignant colonic neoplasms. J Cell Biochem. 1992; 164: 97-101. 13. Loddenkemper R, Minks T, Nitz M, Otte F, Koch M: ABO blood groups as genetic host factors of lung cancer risks. Institute for Klinische Pharmakologie, Freie Universitat, Berlin. 2002; 20: 114-117. 14. Mehrazin M: ABO blood group frequency and brain tumors. Surg Oncol 2002; 13: 110-114. Author Information Kafil Akhtar, M.D.,DMRT Asst. Professor, Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University Ghazala Mehdi, MD Professor, Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University Rana Sherwani, MD Professor, Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University Lateef Ahmad Sofi, MD Senior Resident, Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University Share This Article (c) 2013 Internet Scientific Publications, LLC. All rights reserved.