Chaves P, Cruz C, Cardoso P, Suspiro A, Pereira A Dias, de Almeida J C Mendes, Leitão C N, Soares J
Department of Pathology, Instituto Português de Oncologia de Francisco Gentil, Lisboa, Portugal.
J Exp Clin Cancer Res. 2003 Jun;22(2):273-8.
Barrett's epithelium (BE), the esophageal columnar-lining with intestinal differentiation, is a premalignant condition predisposing to adenocarcinoma. Columnar cells are the prevalent element of BE, but the hallmark of intestinal differentiation is the goblet population that defines the specialised columnar epithelium (SCE). We have demonstrated that columnar cells adjacent to Barrett's adenocarcinoma (BA) exhibit enterocytic features in areas with and without SCE. Nevertheless, the relationship between malignancy and the presence of these elements is not established. To investigate whether intestinal differentiated cells, other than goblet cells, are associated to neoplasia we compared the prevalence of enterocytic features in columnar elements with and without associated BA through the use of sucrase-isomaltase (SI) immunoreactivity in 31 columnar esophageal segments (CLES) and 12 BA. In metaplasia, SI was only expressed at the columnar cells. Apical staining was exclusive of CLES with SCE. SI was present at the cytoplasm in 22.2% of CLES without SCE. Apical SI occurred in BE with and without carcinoma, similarly in areas with and without SCE (p = 0.11 and p = 0.50, respectively). In areas with SCE, columnar cells with apical SI were more frequent in cases of BE adjacent to carcinoma than in cases without neoplasia but the difference did not reach significance (p = 0.053). In areas without SCE, apical SI was significantly (p = 0.01) more frequent in cases with carcinoma. Apical SI was equally found in neoplastic as in metaplastic areas, with and without SCE, (p = 0.07 and p = 0.40, respectively). In conclusion this study on the frequency of SI on CLES with and without neoplasia demonstrated that additionally to SCE, metaplastic enterocytic cells are also associated with malignancy. It also confirmed that the presence of intestinal features are underestimated if only goblet elements are used for its identification, reinforcing the utility of the immunohistochemical recognition of enterocytic characteristics for establishing the diagnosis of BE.
巴雷特食管上皮（BE）是具有肠化生的食管柱状上皮，是腺癌的癌前病变。柱状细胞是BE的主要成分，但肠化生的标志是杯状细胞群，其定义了特殊的柱状上皮（SCE）。我们已经证明，巴雷特腺癌（BA）相邻的柱状细胞在有和没有SCE的区域均表现出肠上皮细胞特征。然而，恶性肿瘤与这些细胞成分之间的关系尚未明确。为了研究除杯状细胞外的肠化生细胞是否与肿瘤形成有关，我们通过对31个柱状食管段（CLES）和12个BA使用蔗糖酶异麦芽糖酶（SI）免疫反应性，比较了有和没有相关BA的柱状细胞中肠上皮细胞特征的发生率。在化生中，SI仅在柱状细胞中表达。顶端染色仅见于有SCE的CLES。22.2%没有SCE的CLES中，SI存在于细胞质中。顶端SI在有癌和无癌的BE中均有出现，在有和没有SCE的区域中相似（分别为p = 0.11和p = 0.50）。在有SCE的区域，与癌相邻的BE病例中，具有顶端SI的柱状细胞比无肿瘤病例更常见，但差异未达到显著水平（p = 0.053）。在没有SCE的区域，顶端SI在有癌的病例中显著更常见（p = 0.01）。顶端SI在肿瘤区域和化生区域（有和没有SCE）中同样常见（分别为p = 0.07和p = 0.40）。总之，这项关于有和没有肿瘤的CLES中SI发生率的研究表明，除了SCE外，化生的肠上皮细胞也与恶性肿瘤有关。它还证实，如果仅使用杯状细胞成分来识别肠特征，则会低估肠特征的存在，这加强了免疫组化识别肠上皮细胞特征在BE诊断中的实用性。
