Kushima R, Mukaisho K-I, Takemura S, Sugihara H, Hattori T, Vieth M
Pathology Division, National Cancer Center Hospital, Tokyo, Japan.
Pathologe. 2013 Mar;34(2):138-47. doi: 10.1007/s00292-012-1731-4.
Whereas attention in the past has been focused on goblet cells as the primary marker for Barrett's esophagus (BE), the recent change in the definition now includes the non-goblet cell columnar cell-lined esophagus. In the present study the histological features of neoplasia of the lower esophagus and esophago-gastric junction in a German cohort were examined using immunohistochemical staining for MUC, CD10, intestinal and gastric type major tight junction proteins (claudins). Experimental studies using rat duodenogastric content reflux models have also been performed and data show that most neoplastic lesions of the esophageal glands in humans express gastric mucin phenotypes. Cardiac type mucosa was the main histological type in the surrounding mucosa of neoplastic lesions; however, most cardiac type mucosa has intestinal type tight junction proteins. BE with goblet cells has been reported to originate from stem cells located in the basal layer of esophageal squamous cell epithelium in previous models. However, the cardiac type mucosa seems to develop from the site of the stomach and not from the basal layer of esophageal squamous cell epithelium according to our model.
过去,注意力主要集中在杯状细胞作为巴雷特食管(BE)的主要标志物上,而现在定义的改变包括了非杯状细胞柱状上皮化生的食管。在本研究中,使用针对MUC、CD10、肠型和胃型主要紧密连接蛋白(claudins)的免疫组织化学染色,对德国队列中下食管和食管胃交界肿瘤的组织学特征进行了检查。还进行了使用大鼠十二指肠胃内容物反流模型的实验研究,数据表明人类食管腺的大多数肿瘤性病变表达胃粘蛋白表型。贲门型黏膜是肿瘤性病变周围黏膜的主要组织学类型;然而,大多数贲门型黏膜具有肠型紧密连接蛋白。在先前的模型中,有杯状细胞的BE被报道起源于食管鳞状上皮基底层的干细胞。然而,根据我们的模型,贲门型黏膜似乎是从胃的部位发展而来,而不是从食管鳞状上皮的基底层发展而来。