title: Classification of Barrett's epithelium by magnifying endoscopy.
abstract: BACKGROUND
  The specialized columnar epithelium of Barrett's esophagus can be detected by obtaining random or 4 quadrant biopsy specimens at conventional endoscopy. However, little is known about the fine mucosal structure of specialized columnar epithelium.
  
  
  METHODS
  Thirty patients with Barrett's esophagus were studied by magnifying endoscopy. The fine mucosal pattern (pit pattern) of 67 regions in Barrett's mucosa was recorded and compared with methylene blue staining. Histologic, mucin immunohistologic, and cell proliferation analyses of biopsy specimens were performed in relation to the pit patterns determined by magnifying endoscopy.
  
  
  RESULTS
  Pit pattern was classified into 5 types. Tubular and villous pit patterns were not only characteristics of both specialized columnar epithelium and methylene blue absorption, but also possessed an intestinal mucin phenotype with a high Ki-labeling index, whereas other pit patterns (dot and straight) did not have specialized columnar epithelium and were categorized as the gastric phenotype. The long oval pit pattern had an intermediate phenotype between gastric and intestinal.
  
  
  CONCLUSIONS
  The classification of the superficial mucosal appearance of Barrett's epithelium by magnifying endoscopy reflects not only histologic features but also mucin phenotypes.
authors.affiliation: First Department of Internal Medicine, Sapporo Medical University, Sapporo 060, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Endo
authors.forename: Teruhito
authors.initials: T
authors.lastname: Awakawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Arimura
authors.forename: Fumio
authors.initials: F
authors.lastname: Itoh
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamashita
authors.forename: Sigeru
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Xiufen
authors.initials: X
authors.lastname: Tang
authors.forename: Kohzoh
authors.initials: K
authors.lastname: Imai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000145:classification* / Q000235:genetics / Q000473:pathology*; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D004848:Epithelium / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000235:genetics; D010641:Phenotype; D012680:Sensitivity and Specificity
chemical_list: D009077:Mucins