Chen Wei, Frankel Wendy L, Cronley Kevin M, Yu Lianbo, Zhou Xiaoping, Yearsley Martha M
From the Departments of Pathology and.
Gastroenterology, Hepatology and Nutrition, and.
Am J Clin Pathol. 2015 May;143(5):665-71. doi: 10.1309/AJCPVUJMCVBC9PKM.
The metaplastic intestinal epithelium in Barrett esophagus (BE) occasionally contains Paneth cells; however, little is known regarding the prevalence and significance of Paneth cell metaplasia (PCM) in BE.
We evaluated 757 esophageal biopsy specimens with intestinal metaplasia (IM) for PCM. Outcome analysis was performed in 299 cases with complete clinical data using multinomial logistic regression.
Thirty-one percent (234/757) of the IM cases showed PCM. Paneth cells are decreased when BE epithelium becomes increasingly dysplastic. Long-segment BE shows significantly more PCM than short-segment BE. On follow-up biopsies, patients without PCM (NPCM) are three times more likely to regress than patients with PCM, regardless of dysplasia, BE segment length, age, or sex. However, there is no significant difference in terms of progression to dysplasia/adenocarcinoma between the PCM and NPCM groups.
The presence of PCM is associated with less disease regression and is not associated with more disease progression.
巴雷特食管（BE）中的化生肠上皮偶尔含有潘氏细胞；然而，关于BE中潘氏细胞化生（PCM）的发生率和意义知之甚少。
我们评估了757例伴有肠化生（IM）的食管活检标本中的PCM情况。对299例具有完整临床数据的病例进行多分类逻辑回归分析。
31%（234/757）的IM病例显示有PCM。当BE上皮发育异常程度加重时，潘氏细胞数量减少。长段BE的PCM明显多于短段BE。在随访活检中，无论发育异常情况、BE段长度、年龄或性别如何，无PCM（NPCM）的患者病情消退的可能性是有PCM患者的三倍。然而，PCM组和NPCM组在进展为发育异常/腺癌方面没有显著差异。
PCM的存在与疾病消退较少相关，且与疾病进展较多无关。
