title: Prevalence of mabDAS-1 positivity in biopsy specimens from the esophagogastric junction.
abstract: OBJECTIVE
  Intestinal metaplasia (IM) is a precursor for malignancies at the esophagogastric junction. A monoclonal antibody, mAbDAS-1, can probably identify cellular characteristics of IM before the appearance of goblet cells. The aim of this study was to examine the prevalence of mAbDAS-1 positivity in biopsies from the squamocolumnar junction (SCJ) and to correlate this positivity with the presence of IM and clinical findings.
  
  
  METHODS
  In 559 patients, reflux symptoms were scored, and the presence of reflux esophagitis and hiatus hernia was evaluated during endoscopy. Two biopsy specimens were obtained from the SCJ. In a subset of patients (n = 99), biopsies from the endoscopically defined cardiac region (2 cm distal to proximal margin of gastric folds) were available. Biopsy specimens were stained with hematoxylin and eosin, Alcian Blue, modified Giemsa, and mAbDAS-1.
  
  
  RESULTS
  mAbDAS-1 positivity was observed in the SCJ biopsies of 201 of 486 (41.4%) patients without IM and in 64 of 73 (87.7%) patients with IM. Patients without IM but with antibody positivity showed similar histological characteristics as patients with IM at the SCJ. Biopsies of 123 of 559 patients (22%) revealed a columnar-cuboidal epithelium, which was found to be mAbDAS-1 positive in 64.2% (77 of 123). Tissue specimens from the cardiac region without IM stained positive in 14.2% (13 of 91), 12 of those also stained at the SCJ.
  
  
  CONCLUSIONS
  In patients without IM, a high prevalence of mAbDAS-1 positivity was observed. Biopsies of these patients showed similar histological characteristics as patients with IM. Although not all patients exhibiting this reactivity may develop IM, mAbDAS-1 reactivity may help in the understanding of the histogenesis of IM at the SCJ.
authors.affiliation: Department of Gastroenterology, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rogge-Wolf
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Seldenrijk
authors.forename: Kiron M
authors.initials: KM
authors.lastname: Das
authors.forename: Robin
authors.initials: R
authors.lastname: Timmer
authors.forename: Ronald
authors.initials: R
authors.lastname: Breumelhof
authors.forename: André J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: Peter S
authors.initials: PS
authors.lastname: Amenta
authors.forename: Louis H
authors.initials: LH
authors.lastname: Griffel
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D001706:Biopsy; D004724:Endoscopy; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013270:Stomach / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal