title: Multilayered epithelium may be found in patients with Barrett's epithelium and dysplasia or adenocarcinoma.
abstract: To determine if multilayered epithelium (MLE) is a useful prognostic indicator for a benign natural history of Barrett's epithelium, we evaluated endoscopic biopsies from patients with Barrett's epithelium without and with dysplasia and/or adenocarcinoma and from non-Barrett's controls for the presence of MLE. MLE was found in 6% of non-Barrett's controls, 30% of Barrett's patients with no dysplasia, and 14% of Barrett's patients with dysplasia and/or adenocarcinoma. MLE was significantly associated with shorter lengths of Barrett's epithelium in both Barrett's groups. Three of 5 photodynamic therapy patients were noted to develop MLE after therapy. MLE may be found in patients with dysplasia and/or adenocarcinoma and after photodynamic therapy; its presence is not useful as a prognostic indicator for a more benign course of Barrett's. This study confirms that MLE is significantly associated with shorter lengths of Barrett's epithelium.
authors.affiliation: Department of Pathology, University of Washington Medical Center, University of Washington Medical School, Seattle, Washington, USA.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: Upton
authors.forename: Norman S
authors.initials: NS
authors.lastname: Nishioka
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Ransil
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Rosenberg
authors.forename: William P
authors.initials: WP
authors.lastname: Puricelli
authors.forename: Felice R
authors.initials: FR
authors.lastname: Zwas
authors.forename: Helen M
authors.initials: HM
authors.lastname: Shields
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000188:drug therapy / Q000473:pathology*; D016022:Case-Control Studies; D004848:Epithelium / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D012720:Severity of Illness Index