title: Immunohistochemical analysis of metaplastic non-goblet columnar lined oesophagus shows phenotypic similarities to Barrett's oesophagus: a study in an Asian population.
abstract: BACKGROUND
  Barrett's oesophagus is a premalignant condition, predisposing to oesophageal adenocarcinoma. However, some adenocarcinoma may arise in columnar lined oesophagus without goblet cells. Our aim was to evaluate the biological properties of non-goblet columnar lined oesophagus only and elucidate its relationship with Barrett's oesophagus and associated neoplasia.
  
  
  METHODS
  Endoscopic biopsies from patients with Barrett's oesophagus (n=30), non-goblet columnar lined oesophagus (n=14), Barrett's oesophagus associated high grade dysplasia (n=6) and adenocarcinoma (n=4) were selected. Immunostaining for villin, claudin 3 and MUC4 was performed. Statistical analysis was performed and a p value <0.05 was considered significant.
  
  
  RESULTS
  Villin and MUC4 were positive in 42%, 100% each and 50% in non-goblet columnar lined oesophagus, Barrett's oesophagus, high grade dysplasia and adenocarcinoma respectively, while claudin 3 was 100% positive in all the groups. In non-goblet columnar lined oesophagus, six cases that were villin immunopositive, showed positive expression for claudin 3 and/or MUC4 and there was no difference from the high grade dysplasia or adenocarcinoma (p>0.05).
  
  
  CONCLUSIONS
  Our results indicate that a subset of non-goblet columnar lined oesophagus shows an intestinal phenotype representing an early stage of Barrett's oesophagus. This subset probably harbours the potential to change into adenocarcinoma in the long term.
authors.affiliation: Cancer Science Institute, National University of Singapore, Singapore.
authors.forename: Supriya
authors.initials: S
authors.lastname: Srivastava
authors.affiliation: Genome Institute of Singapore, A-STAR, Singapore.
authors.forename: Mei Shan
authors.initials: MS
authors.lastname: Liew
authors.affiliation: Department of Cell Biology, Harvard Medical School, Boston, MA, USA; Genome Institute of Singapore, A-STAR, Singapore.
authors.forename: Frank
authors.initials: F
authors.lastname: McKeon
authors.affiliation: Departments of Pathology, Brigham and Women's Hospital, Boston, MA, USA; Institute of Medical Biology, A-STAR, Singapore.
authors.forename: Wa
authors.initials: W
authors.lastname: Xian
authors.affiliation: Department of Medicine, National University Health System, Singapore.
authors.forename: Khay Guan
authors.initials: KG
authors.lastname: Yeoh
authors.affiliation: Department of Medicine, National University Health System, Singapore.
authors.forename: Khek Yu
authors.initials: KY
authors.lastname: Ho
authors.affiliation: Department of Pathology, National University Health System, Singapore. Electronic address: ming_teh@nuhs.edu.sg.
authors.forename: Ming
authors.initials: M
authors.lastname: Teh
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001471:Barrett Esophagus / Q000378:metabolism* / Q000473:pathology; D062465:Claudin-3 / Q000378:metabolism*; D004847:Epithelial Cells / Q000378:metabolism* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000473:pathology; D005260:Female; D020397:Goblet Cells / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism*; D008875:Middle Aged; D055264:Mucin-4 / Q000378:metabolism*; D010641:Phenotype
chemical_list: C568122:CLDN3 protein, human; D062465:Claudin-3; C524658:MUC4 protein, human; D008840:Microfilament Proteins; D055264:Mucin-4
keywords: Barrett's oesophagus; Claudin 3; Columnar lined oesophagus; MUC4; Oesophageal adenocarcinoma