title: High Goblet Cell Count Is Inversely Associated with Ploidy Abnormalities and Risk of Adenocarcinoma in Barrett's Esophagus.
abstract: OBJECTIVE
  Goblet cells may represent a potentially successful adaptive response to acid and bile by producing a thick mucous barrier that protects against cancer development in Barrett's esophagus (BE). The aim of this study was to determine the relationship between goblet cells (GC) and risk of progression to adenocarcinoma, and DNA content flow cytometric abnormalities, in BE patients.
  
  
  METHODS
  Baseline mucosal biopsies (N=2988) from 213 patients, 32 of whom developed cancer during the follow up period, enrolled in a prospective dynamic cohort of BE patients were scored in a blinded fashion, for the total number (#) of GC, mean # of GC/crypt (GC density), # of crypts with ≥ 1 GC, and the proportion of crypts with ≥1 GC, in both dysplastic and non-dysplastic epithelium separately. The relationship between these four GC parameters and DNA content flow cytometric abnormalities and adenocarcinoma outcome was compared, after adjustment for age, gender, and BE segment length.
  
  
  RESULTS
  High GC parameters were inversely associated with DNA content flow cytometric abnormalities, such as aneuploidy, ploidy >2.7N, and an elevated 4N fraction > 6%, and with risk of adenocarcinoma. However, a Kaplan-Meier analysis showed that the total # of GC and the total # crypts with ≥1 GC were the only significant GC parameters (p<0.001 and 0.003, respectively).
  
  
  CONCLUSIONS
  The results of this study show, for the first time, an inverse relationship between high GC counts and flow cytometric abnormalities and risk of adenocarcinoma in BE. Further studies are needed to determine if GC depleted foci within esophageal columnar mucosa are more prone to neoplastic progression or whether loss of GC occurs secondary to underlying genetic abnormalities.
authors.affiliation: Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Golden
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Carissa A
authors.initials: CA
authors.lastname: Sanchez
authors.affiliation: Department of Vaccine Infectious Disease Institute, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Karen
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Pui Yee
authors.initials: PY
authors.lastname: Fong
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: David S
authors.initials: DS
authors.lastname: Cowan
authors.affiliation: Department of Pathology, University of Washington, Seattle, Washington, United States of America.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Rabinovitch
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Medicine, University of Washington, Seattle, Washington, United States of America; Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Reid
authors.affiliation: Department of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America; Department of Medicine, University of Washington, Seattle, Washington, United States of America.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Blount
authors.affiliation: Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Odze
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology*; D000368:Aged; D001471:Barrett Esophagus / Q000235:genetics / Q000473:pathology*; D001706:Biopsy; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004247:DNA / Q000235:genetics; D004938:Esophageal Neoplasms / Q000235:genetics / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D020397:Goblet Cells / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology; D011446:Prospective Studies; D012306:Risk
chemical_list: D004247:DNA