Fennerty M B, Sampliner R E, Way D, Riddell R, Steinbronn K, Garewal H S
Veterans Administration Medical Center, Hamilton, Ontario, Canada.
Gastroenterology. 1989 Oct;97(4):815-20. doi: 10.1016/0016-5085(89)91483-2.
Eighty-six specimens from 25 patients with Barrett's epithelium were analyzed by both histology and flow cytometry. Of these, 73 were without dysplasia and 13 had dysplasia (7 low grade, 6 high grade). Eight of the nondysplastic specimens were aneuploid and another 15 had increased G2. Among the dysplastic specimens, two were aneuploid and two had increased G2. These data were grouped into four classifications: type 1 (65 specimens), specialized columnar epithelium (Barrett's) without dysplasia and no aneuploidy; type 2 (8 specimens), Barrett's epithelium without dysplasia and an aneuploid cell population; type 3 (11 specimens), Barrett's epithelium with dysplasia and no aneuploidy; and type 4 (2 specimens), Barrett's epithelium with dysplasia and aneuploidy. Distribution by type was 76%, 9%, 13%, and 2%, respectively. We conclude that histologic dysplasia and aneuploidy are often discordant. They may identify separate subgroups at risk, or when concordant, may reflect an increased cancer risk in that population. Further study will define the role of histology and flow cytometry in the screening and management of patients with Barrett's esophagus.
对25例患有巴雷特上皮的患者的86份标本进行了组织学和流式细胞术分析。其中，73份无发育异常，13份有发育异常（7份低级别，6份高级别）。8份无发育异常的标本为非整倍体，另外15份G2期增加。在发育异常的标本中，2份为非整倍体，2份G2期增加。这些数据被分为四类：1型（65份标本），无发育异常且无非整倍体的特殊柱状上皮（巴雷特上皮）；2型（8份标本），无发育异常但有非整倍体细胞群的巴雷特上皮；3型（11份标本），有发育异常但无非整倍体的巴雷特上皮；4型（2份标本），有发育异常且有非整倍体的巴雷特上皮。各类型的分布分别为76%、9%、13%和2%。我们得出结论，组织学上的发育异常和非整倍体常常不一致。它们可能识别出不同的高危亚组，或者当二者一致时，可能反映出该人群患癌风险增加。进一步的研究将明确组织学和流式细胞术在巴雷特食管患者筛查和管理中的作用。
