title: Barrett's esophagus is characterized by expression of gastric-type mucins (MUC5AC, MUC6) and TFF peptides (TFF1 and TFF2), but the risk of carcinoma development may be indicated by the intestinal-type mucin, MUC2.
abstract: Barrett's esophagus (BE) consists of metaplastic epithelium of the esophagus, generally diagnosed by mucin histochemistry. We aimed to determine which mucins were expressed in BE, and to relate their expression to BE pathology. Archival biopsies of 4 patient groups were selected, based on standard histochemistry: BE without inflammation, BE with inflammation, ulcerating BE, and BE with dysplasia. Sections were stained by immunohistochemistry for secretory mucins (MUC2, MUC5AC, MUC5B, and MUC6), the proliferation marker Ki-67, and mucin-associated trefoil factor family (TFF) peptides (TFF1, TFF2, and TFF3). MUC5AC and TFF2 were expressed at similar high levels in each clinical group. Intestinal metaplasia (IM), detected both histochemically and by the intestinal mucin MUC2, was lowest in inflamed BE. The expression of the intestinal-type TFF3 did not differ among the groups. Ulcerating BE was distinguished by very low expression of MUC6 and MUC5B, but very high expression of TFF1. Proliferation was not different among the groups. In the total group of BE patients, H. pylori infection of the stomach correlated with decreased TFF2 expression in the BE epithelium. We conclude that BE is best characterized by the specific expression of the gastric-type markers, MUC5AC, MUC6, TFF1, and TFF2. Ulcerating BE constitutes the most distinguished group with respect to mucin and TFF expression. Of the intestinal markers, MUC2 is very specific for IM in BE, whereas TFF3 is not a marker for IM. The low occurrence of IM in inflamed BE suggests that these patients may have the lowest risk of developing carcinoma.
authors.affiliation: Gastrointestinal Pathology Unit, Catholic University Leuven, Belgium.
authors.forename: Christian
authors.initials: C
authors.lastname: Warson
authors.forename: Jeroen H B
authors.initials: JH
authors.lastname: Van De Bovenkamp
authors.forename: Anita M
authors.initials: AM
authors.lastname: Korteland-Van Male
authors.forename: Hans A
authors.initials: HA
authors.lastname: Büller
authors.forename: Alexandra W C
authors.initials: AW
authors.lastname: Einerhand
authors.forename: Nadine L E Y
authors.initials: NL
authors.lastname: Ectors
authors.forename: Jan
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000378:metabolism* / Q000382:microbiology; D014408:Biomarkers, Tumor; D004938:Esophageal Neoplasms / Q000209:etiology*; D006133:Growth Substances / Q000096:biosynthesis*; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008875:Middle Aged; D055271:Mucin 5AC; D055262:Mucin-2; D055272:Mucin-6; D009077:Mucins / Q000032:analysis* / Q000096:biosynthesis*; D009124:Muscle Proteins; D009479:Neuropeptides; D010455:Peptides; D014176:Protein Biosynthesis; D011506:Proteins; D012189:Retrospective Studies; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins
chemical_list: D014408:Biomarkers, Tumor; D006133:Growth Substances; C524625:MUC2 protein, human; C524678:MUC5AC protein, human; C524734:MUC6 protein, human; C524628:Muc2 protein, rat; C524680:Muc5ac protein, rat; C524736:Muc6 protein, rat; D055271:Mucin 5AC; D055262:Mucin-2; D055272:Mucin-6; D009077:Mucins; D009124:Muscle Proteins; D009479:Neuropeptides; D010455:Peptides; D011506:Proteins; C051838:TFF1 protein, human; C000604007:TFF2 protein, human; C082495:TFF3 protein, human; C099037:TFF3 protein, rat; C000604008:Tff2 protein, rat; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins