Takubo K, Sasajima K, Yamashita K, Tanaka Y, Fujita K
Department of Pathology, Saitama Cancer Center, Japan.
Hum Pathol. 1991 Nov;22(11):1158-61. doi: 10.1016/0046-8177(91)90270-y.
To clarify the histology and morphogenesis of the double muscularis mucosae in Barrett's esophagus, eight specimens resected from patients with Barrett's esophagus were compared histopathologically with 352 specimens resected from patients without Barrett's esophagus. A double muscularis mucosae was observed in seven (87.5%) of the eight cases with Barrett's esophagus, but in none of the 352 cases without Barrett's esophagus. The mucosa in the segment of Barrett's esophagus consisted of columnar epithelium, a superficial lamina propria, a superficial muscularis mucosae, a deep lamina propria, and a deep muscularis mucosae. The distal end of the superficial muscularis mucosae was connected to the deep muscularis mucosae at the esophagogastric junction, and its proximal end was located in fibrous tissue below the squamocolumnar junction of the mucosal epithelium or the distal edge of the erosive lesion. The deep muscularis mucosae in the portion with Barrett's esophagus was continuous with the original muscularis mucosae of the proximal esophagus and muscularis mucosae of the stomach. Barrett's esophagus is considered to be not merely a metaplastic lesion within the epithelium, but a newly developed lesion containing columnar epithelium, lamina propria, and a superficial muscularis mucosae on the lamina propria of the esophageal mucosa.
为阐明巴雷特食管双黏膜肌层的组织学和形态发生，对8例巴雷特食管患者切除的标本与352例非巴雷特食管患者切除的标本进行了组织病理学比较。8例巴雷特食管患者中有7例（87.5%）观察到双黏膜肌层，但352例非巴雷特食管患者中均未观察到。巴雷特食管段的黏膜由柱状上皮、浅层固有层、浅层黏膜肌层、深层固有层和深层黏膜肌层组成。浅层黏膜肌层的远端在食管胃交界处与深层黏膜肌层相连，其近端位于黏膜上皮鳞柱状交界处下方的纤维组织中或糜烂性病变的远端边缘。巴雷特食管部分的深层黏膜肌层与近端食管的原始黏膜肌层和胃的黏膜肌层连续。巴雷特食管不仅被认为是上皮内的化生病变，而且是一种新发生的病变，在食管黏膜固有层上包含柱状上皮、固有层和浅层黏膜肌层。
