Immunocytochemical staining of cells in sputum by rat monoclonal antibody 624Hl2 detects lung cancer two years prior to its detection by conventional diagnostic techniques. The antigen recognized by antibody 624Hl2 is a sugar sequence in the glycosphingolipid difucosylneolactonorhexaosylceramide (v(3)FucIII(3)FucnLc(6)Cer). Both fucosyl residues are required for high affinity binding by the antibody.The antigen was expressed in 35 out of 45 specimens of cancer tissue from patients with early stage non small cell lung cancer. There was no correlation between antigen expression and patient survival.