Chaves P, Cruz C, Dias Pereira A, Suspiro A, de Almeida J C M, Leitão C N, Soares J
Grupo de Estudo do Esófago de Barrett, Instituto Português de Oncologia Francisco Gentil, Centro Regional de Oncologia de Lisboa SA, Portugal.
Dis Esophagus. 2005;18(6):383-7. doi: 10.1111/j.1442-2050.2005.00520.x.
Intestinal metaplasia is a prerequisite criterion for the diagnosis of Barrett's metaplasia and the sole columnar esophageal lining associated with malignancy. It is recognized by the presence of goblet cells, but columnar non-goblet elements, producing gastric or intestinal proteins, are the prevalent cell population. The cellular heterogeneity of Barrett's metaplasia is well documented but the relationship between the distinct cell subtypes and neoplasia is unclear. Our aim was to clarify the relationship between the different metaplastic populations and malignancy in order to investigate putative markers for risk stratification of Barrett's patients. We studied 46 columnar-lined esophageal segments, 15 with associated adenocarcinoma. The presence of the gastric, MUC5AC and MUC6, and the intestinal, MUC2, proteins was evaluated in metaplastic (columnar and goblet) and neoplastic cells. In neoplasia MUC5AC and MUC6 were detected in 100% and 86.6% of the cases, respectively. In metaplasia there were no differences in MUC5AC and MUC6 immunoreactivity, between cases with and without associated neoplasia, except for goblet elements producing MUC6 that were exclusive of metaplasia adjacent to adenocarcinoma (P < 0.05). MUC2 was present in 86.6% of the neoplasia. In metaplasia it was restricted to Barrett's cases and was more frequent in areas with intestinal metaplasia. Columnar-lined esophagus without intestinal metaplasia did not express MUC2. Our study suggests a relationship between the metaplastic population with gastric phenotype and malignancy, and points to the involvement of columnar as well as goblet elements in tumorigenesis. The association between goblet cells aberrantly producing MUC6 and the presence of neoplasia suggests they may be useful for risk stratification.
肠化生是诊断巴雷特化生的必要标准，也是与恶性肿瘤相关的唯一柱状食管内衬。它通过杯状细胞的存在得以识别，但产生胃或肠蛋白的柱状非杯状细胞成分是主要的细胞群体。巴雷特化生的细胞异质性已有充分记录，但不同细胞亚型与肿瘤形成之间的关系尚不清楚。我们的目的是阐明不同化生群体与恶性肿瘤之间的关系，以便研究巴雷特患者风险分层的假定标志物。我们研究了46个柱状食管段，其中15个伴有腺癌。在化生（柱状和杯状）细胞及肿瘤细胞中评估胃蛋白MUC5AC和MUC6以及肠蛋白MUC2的存在情况。在肿瘤中，分别有100%和86.6%的病例检测到MUC5AC和MUC6。在化生中，伴有和不伴有相关肿瘤的病例之间，MUC5AC和MUC6免疫反应性没有差异，除了产生MUC6的杯状细胞成分仅见于腺癌旁的化生（P < 0.05）。86.6%的肿瘤中存在MUC2。在化生中，它仅限于巴雷特病例，且在有肠化生的区域更常见。无肠化生的柱状食管不表达MUC2。我们的研究表明具有胃表型的化生群体与恶性肿瘤之间存在关联，并指出柱状细胞以及杯状细胞成分参与肿瘤发生。异常产生MUC6的杯状细胞与肿瘤存在之间的关联表明它们可能有助于风险分层。
