Mucin histochemistry of intestinal metaplasia in Barrett's esophagus.
Histological and histochemical evaluation of 33 biopsies and 8 distal esophagectomy specimens revealed specialized columnar epithelium with intestinal features [intestinal metaplasia (IM)] to be the most common type (91%) of metaplasia in Barrett's esophagus (BE). Junctional epithelium was found in only 3 of the 33 biopsies. The type III subvariety of IM (TIII-M), characterized by the presence of sulfomucins in the non-goblet columnar cells, was found in 58% of all our biopsies and 62% of operative specimens. Six of the 7 cases of epithelial dysplasia were associated with TIII-M; one of them subsequently developed an adenocarcinoma. The transitional epithelium adjacent to adenocarcinomas in the operative specimens also showed TIII-M in five of six cases. Our findings indicate that TIII-M is almost as common in Barrett's-associated carcinoma as in nonneoplastic cases of BE, thereby limiting the usefulness of this histological marker as an indicator of neoplastic change (P = 0.5). On the other hand, TIII-M seems to be significantly associated with mild dysplasia in BE. The value of TIII-M as a prognostic indicator regarding the subsequent development of esophageal carcinoma remains in doubt and could be more precisely assessed by a prospective study.
Jauregui
H O
HO
Department of Pathology, Rhode Island Hospital, Brown University.
Davessar
K
K
Hale
J H
JH
Kessimian
N
N
Cenoz
C
C
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D001471:Barrett Esophagus / Q000378:metabolism* / Q000473:pathology; D001706:Biopsy; D004848:Epithelium / Q000473:pathology; D004938:Esophageal Neoplasms / Q000378:metabolism / Q000473:pathology; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D006651:Histocytochemistry; D006801:Humans; D007422:Intestines / Q000473:pathology* / Q000648:ultrastructure; D008679:Metaplasia / Q000473:pathology; D009077:Mucins / Q000378:metabolism*
D009077:Mucins; C012564:sulfomucin