Azuma N, Endo T, Arimura Y, Motoya S, Itoh F, Hinoda Y, Irimura T, Hosokawa M, Imai K
First Department of Internal Medicine, Sapporo Medical University, Japan.
J Gastroenterol. 2000;35(8):583-92. doi: 10.1007/s005350070057.
Barrett's esophagus (BE) is an acquired disorder associated with a high incidence of adenocarcinoma of the lower esophagus. Moreover, it has been reported that short-segment BE may be associated with adenocarcinoma of the esophagogastric junction. The objective of this study was to define the prevalence of BE and the mucin profile in BE, including the short-segment type, and to compare the mucin profile in BE with the profiles of Barrett's adenocarcinoma and distal esophageal adenocarcinoma among Japanese. In total, 650 adult subjects underwent endoscopic examination for evaluation of BE. Although the prevalence of traditional (long segment) BE was 0.62%, the overall prevalence of BE including short-segment type was 15.7%. In Barrett's epithelium, the short-segment type predominantly had gastric type mucin, while the middle- and long-segment types possessed intestinal mucin, especially colonic type mucin (sulfo-Lewis(a)), with high frequency. In Barrett's epithelium with adenocarcinoma, all Barrett's epithelium adjacent to carcinomas showed a predominance of immunoreactivity to sulfo-Lewis(a). In Barrett's adenocarcinomas, colonic type mucin was detected in 100% by monoclonal antibody (MoAb) 91.9H. Small-intestinal mucin and gastric mucin were stained in 50% and 12.5% of the subjects, respectively. Colonic type mucin was also detected with high frequency (80%) in distal esophageal adenocarcinomas without Barrett's epithelium. These data suggest that the epitope, not of small-intestinal type or gastric type mucin, but of colonic type mucin (sulfo-Lewis(a)), may be associated with, at least in part, the malignant phenotype of BE.
巴雷特食管（BE）是一种后天性疾病，与食管下段腺癌的高发病率相关。此外，有报道称短节段BE可能与食管胃交界腺癌有关。本研究的目的是确定BE的患病率以及BE（包括短节段型）中的黏蛋白谱，并比较日本人群中BE的黏蛋白谱与巴雷特腺癌和远端食管腺癌的黏蛋白谱。总共650名成年受试者接受了内镜检查以评估BE。虽然传统（长节段）BE的患病率为0.62%，但包括短节段型在内的BE总体患病率为15.7%。在巴雷特上皮中，短节段型主要具有胃型黏蛋白，而中节段型和长节段型则高频拥有肠黏蛋白，尤其是结肠型黏蛋白（磺基 - 路易斯(a)）。在伴有腺癌的巴雷特上皮中，所有与癌相邻的巴雷特上皮对磺基 - 路易斯(a)均表现出免疫反应性占优势。在巴雷特腺癌中，单克隆抗体（MoAb）91.9H检测到100%的结肠型黏蛋白。小肠黏蛋白和胃黏蛋白分别在50%和12.5%的受试者中被染色。在无巴雷特上皮的远端食管腺癌中也高频检测到结肠型黏蛋白（80%）。这些数据表明，至少部分与BE恶性表型相关的抗原决定簇不是小肠型或胃型黏蛋白的，而是结肠型黏蛋白（磺基 - 路易斯(a)）的。
