title: Is cytokeratin immunoreactivity useful in the diagnosis of short-segment Barrett's oesophagus in Korea?
abstract: 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%.
authors.affiliation: Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Rok Son
authors.initials: RS
authors.lastname: Choung
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Kim
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
authors.forename: Chi Wook
authors.initials: CW
authors.lastname: Song
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bak
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
authors.forename: Jin Hai
authors.initials: JH
authors.lastname: Hyun
authors.forename: Dae Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Kim
mesh_terms: 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
chemical_list: D015415:Biomarkers; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins