Is cytokeratin immunoreactivity useful in the diagnosis of short-segment Barrett's oesophagus in Korea?
BACKGROUND
Cytokeratin 7/20 staining has been reported to be helpful in diagnosing Barrett's oesophagus and gastric intestinal metaplasia. However, this is still a matter of some controversy.


OBJECTIVE
To determine the diagnostic usefulness of cytokeratin 7/20 immunostaining for short-segment Barrett's oesophagus in Korea.


METHODS
In patients with Barrett's oesophagus, diagnosed endoscopically, at least two biopsy specimens were taken from just below the squamocolumnar junction. If goblet cells were found histologically with alcian blue staining, cytokeratin 7/20 immunohistochemical stains were performed. Intestinal metaplasia at the cardia was diagnosed whenever biopsy specimens taken from within 2 cm below the oesophagogastric junction revealed intestinal metaplasia. Barrett's cytokeratin 7/20 pattern was defined as cytokeratin 20 positivity in only the superficial gland, combined with cytokeratin 7 positivity in both the superficial and deep glands.


RESULTS
Barrett's cytokeratin 7/20 pattern was observed in 28 out of 36 cases (77.8%) with short-segment Barrett's oesophagus, 11 out of 28 cases (39.3%) with intestinal metaplasia at the cardia, and nine out of 61 cases (14.8%) with gastric intestinal metaplasia. The sensitivity and specificity of Barrett's cytokeratin 7/20 pattern were 77.8 and 77.5%, respectively.


CONCLUSIONS
Barrett's cytokeratin 7/20 pattern can be a useful marker for the diagnosis of short-segment Barrett's oesophagus, although the false positive or false negative rate is approximately 25%.
Yim
Hyung Joon
HJ
Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea.
Lee
Sang Woo
SW
Choung
Rok Son
RS
Kim
Young Sun
YS
Kim
Jin Yong
JY
Lee
Hong Sik
HS
Song
Chi Wook
CW
Choi
Jai Hyun
JH
Bak
Young-Tae
YT
Ryu
Ho Sang
HS
Hyun
Jin Hai
JH
Kim
Dae Soo
DS
Kim
Chul Hwan
CH
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002299:Cardia / Q000737:chemistry / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007381:Intermediate Filament Proteins / Q000032:analysis*; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins / Q000032:analysis*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology
D015415:Biomarkers; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins