title: Significance of paneth cell metaplasia in Barrett esophagus: a morphologic and clinicopathologic study.
abstract: OBJECTIVE
  The metaplastic intestinal epithelium in Barrett esophagus (BE) occasionally contains Paneth cells; however, little is known regarding the prevalence and significance of Paneth cell metaplasia (PCM) in BE.
  
  
  METHODS
  We evaluated 757 esophageal biopsy specimens with intestinal metaplasia (IM) for PCM. Outcome analysis was performed in 299 cases with complete clinical data using multinomial logistic regression.
  
  
  RESULTS
  Thirty-one percent (234/757) of the IM cases showed PCM. Paneth cells are decreased when BE epithelium becomes increasingly dysplastic. Long-segment BE shows significantly more PCM than short-segment BE. On follow-up biopsies, patients without PCM (NPCM) are three times more likely to regress than patients with PCM, regardless of dysplasia, BE segment length, age, or sex. However, there is no significant difference in terms of progression to dysplasia/adenocarcinoma between the PCM and NPCM groups.
  
  
  CONCLUSIONS
  The presence of PCM is associated with less disease regression and is not associated with more disease progression.
authors: From the Departments of Pathology and.
authors: Wei
authors: W
authors: Chen
authors: From the Departments of Pathology and.
authors: Wendy L
authors: WL
authors: Frankel
authors: Gastroenterology, Hepatology and Nutrition, and.
authors: Kevin M
authors: KM
authors: Cronley
authors: Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus.
authors: Lianbo
authors: L
authors: Yu
authors: From the Departments of Pathology and.
authors: Xiaoping
authors: X
authors: Zhou
authors: From the Departments of Pathology and Martha.Yearsley@osumc.edu.
authors: Martha M
authors: MM
authors: Yearsley
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology*; D001706:Biopsy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D019879:Paneth Cells / Q000473:pathology*; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012044:Regression Analysis; D055815:Young Adult
keywords: Barrett esophagus; Dysplasia; Esophageal adenocarcinoma; GERD; Paneth cell