Intestinal Differentiation in Metaplastic, Nongoblet Columnar Epithelium in the Esophagus

• DOI: 10.1097/pas.0b013e31819f57e9
• Publication Date: 2009-06-24T12:49:23Z
• Authors: Hejin P. Hahn; Patricia L. Blount; Kamrun Ayub; Kiron M. Das; Rhonda Souza; Stuart Spechler; Robert D. Odze
• Keywords: Villin; Goblet cell; Columnar Cell; Metaplasia; Intestinal metaplasia; CDX2; Barrett's esophagus; Foveolar cell; Mucin 2

Barrett esophagus (BE) is defined by the presence of metaplastic esophageal columnar epithelium with goblet cells within endoscopically recognizable areas esophagus. However, some carcinomas in BE, or from gastroesophageal junction region, develop mucosa devoid cells. biologic properties, pathogenesis, and risk malignancy metaplastic, nongoblet epithelium, is, essentially, unknown. In this study, 89 patients were evaluated immunohistochemically for markers intestinal differentiation, such as MUC2, DAS-1, Villin, CDX2, a marker gastric differentiation (MUC5AC), Ki67, cell proliferation. Of patients, 59 had metaplasia (BE), which further separated into low-density high-density groups based on percentage crypts cells, 30 without As controls, biopsies 19 age sex matched pathology used. The rate positivity location Ki67 staining was only non-goblet all patient groups. Patients showed MUC5AC, CDX2 100%, 0%, 30%, 17%, 43% cases, respectively. 17% cases aberrant surface positivity. These values significantly higher than absence except MUC5AC (100%). significant increased observed markers, MUC5AC. addition, both MUC2 BE versus those separate analysis compared who elsewhere (N=59), no differences regard to that stained any similar group (N=30). Similar above, expression adjacent This study provides evidence shows phenotypic supports theory squamous converts initially before metaplasia. Further prospective studies are needed evaluate pathogenetic sequence, natural history, epithelium.