Warson Christian, Van De Bovenkamp Jeroen H B, Korteland-Van Male Anita M, Büller Hans A, Einerhand Alexandra W C, Ectors Nadine L E Y, Dekker Jan
Gastrointestinal Pathology Unit, Catholic University Leuven, Belgium.
Hum Pathol. 2002 Jun;33(6):660-8. doi: 10.1053/hupa.2002.124907.
Barrett's esophagus (BE) consists of metaplastic epithelium of the esophagus, generally diagnosed by mucin histochemistry. We aimed to determine which mucins were expressed in BE, and to relate their expression to BE pathology. Archival biopsies of 4 patient groups were selected, based on standard histochemistry: BE without inflammation, BE with inflammation, ulcerating BE, and BE with dysplasia. Sections were stained by immunohistochemistry for secretory mucins (MUC2, MUC5AC, MUC5B, and MUC6), the proliferation marker Ki-67, and mucin-associated trefoil factor family (TFF) peptides (TFF1, TFF2, and TFF3). MUC5AC and TFF2 were expressed at similar high levels in each clinical group. Intestinal metaplasia (IM), detected both histochemically and by the intestinal mucin MUC2, was lowest in inflamed BE. The expression of the intestinal-type TFF3 did not differ among the groups. Ulcerating BE was distinguished by very low expression of MUC6 and MUC5B, but very high expression of TFF1. Proliferation was not different among the groups. In the total group of BE patients, H. pylori infection of the stomach correlated with decreased TFF2 expression in the BE epithelium. We conclude that BE is best characterized by the specific expression of the gastric-type markers, MUC5AC, MUC6, TFF1, and TFF2. Ulcerating BE constitutes the most distinguished group with respect to mucin and TFF expression. Of the intestinal markers, MUC2 is very specific for IM in BE, whereas TFF3 is not a marker for IM. The low occurrence of IM in inflamed BE suggests that these patients may have the lowest risk of developing carcinoma.
巴雷特食管（BE）由食管化生上皮组成，通常通过黏液组织化学进行诊断。我们旨在确定哪些黏蛋白在BE中表达，并将它们的表达与BE病理学联系起来。基于标准组织化学，选择了4组患者的存档活检样本：无炎症的BE、有炎症的BE、溃疡性BE和有发育异常的BE。切片通过免疫组织化学染色检测分泌性黏蛋白（MUC2、MUC5AC、MUC5B和MUC6）、增殖标志物Ki-67以及黏蛋白相关三叶因子家族（TFF）肽（TFF1、TFF2和TFF3）。MUC5AC和TFF2在每个临床组中均以相似的高水平表达。通过组织化学和肠道黏蛋白MUC2检测到的肠化生（IM）在炎症性BE中最低。肠型TFF3的表达在各组之间没有差异。溃疡性BE的特征是MUC6和MUC5B表达极低，但TFF1表达极高。各组之间的增殖情况没有差异。在所有BE患者组中，胃幽门螺杆菌感染与BE上皮中TFF2表达降低相关。我们得出结论，BE的最佳特征是胃型标志物MUC5AC、MUC6、TFF1和TFF2的特异性表达。就黏蛋白和TFF表达而言，溃疡性BE是最具特征的一组。在肠道标志物中，MUC2对BE中的IM非常特异，而TFF3不是IM的标志物。炎症性BE中IM的发生率较低，表明这些患者发生癌变的风险可能最低。
