Cytoqueratina 7 y 20 in Barrett's esophagus
DOI:
https://doi.org/10.31053/1853.0605.v62.n3.32530Keywords:
Barrets esophagus CK 7 and 20 inmunoreactivity patternsAbstract
TRABAJOS DE ACTUALIZACIÓN CITOQUERATINAS 7 Y 20 EN EL ESÓFAGO DE BARRETT CYTOKERATINA 7 AND 20 IN BARRETT'S ESOPHAGUS Dres. Antonio Arra, Norma B. Nieva, Natividad Rey, Angel O. Fernández Servicio de Patología Hospital Escuela de la Universidad Abierta Interamericana. Quimo 91 811 A (1406) Floresta. Capital Federal. Tel/fax: 011 4612 6209 - aarra@intrarned.net.ar ABSTRACT Barrett's esophagus (BE) has been identified as the niost important risk factor for adenocarcinoma of the distal esophagus. BE has been categorized as long-segment (LSBE) if it extends 3 cm or more up the esophagus and as short-segrnent (SSBE) if it extends less than 3 cm unto esophagus. Intestinal metaplasia may also develop in gastric mucosa (IMG) at the gastroesophagealjunction. IMG has a much lower risk to progress to dysplasia or carcinoma when compared with SLBE or SSBE. Moreover, these conditions are difficult to distinguish one from another only based on endoscopic and morphologic criteria. Therefore the aún this study was to evaluate the cytokeratin (CK) 7 and 20 inmnunoreactivity patterns in these intestinal metaplasias with the purpose to determine the precise anatomic site of the biopsy. Biopsy specimens from 14 patients with LSBE, 6 with SSBE and 7 patients with ¡MG were inrnunohistochemically stained with monoclonal antibodies to CK 7 and 20. Barrett's CK7/20 pattern was characterized by superficial and deep CK7 reactivity and only superficial CK 20 staining in the intestinalized mucosa. This pattern was found in all 7 (100%) patients with LSBE, and was absent III all 7 patients with IMG. AII biopsy specimens from patients with IMG showed no staining for CK7 and diffuse surface positivity for CK20. 67% of the biopsy specimens from patients with endoscopic SSBE showed Barrett's CK7/20 pattern, and the remaining 33% specimens showed the IMG staining pattern. Based en our data the inmunohistochemical determination of CK7/20 is an excelent tool with high specificity in distinguishing LSBE and SSBE from IMG.Downloads
References
Dent J, Bremner CG, Collen MJ. Working Party Report to the World Congresses of Gastroenterology, Sydney, 1990: Barrett's esophagus. J Gastroenterol Hepatol; 1991, 6: 1-22.
Haggitt RC. Barrett's esophagus, dysplasia and adenocarcinoma. Hum Pathol; 1994, 25: 982-993.
Cameron AJ, lomboy CT. Barrett's esophagus: age, prevalence and extent of columnar epithelium. Gastroenterolo,; 1992, 103: 1241-1245. Trudgill NJ, Suvarna SK, Kapur KC, Riley SA. Intestinal metaplasia at the squamocolumnar junction in patients attending for diagnostic gastrocopy. Gut; 1997,41:585-589.
Drewitz DJ, Stampliner RE, Garewal HS. The incidence of adenocarcinoma In Barrett's esophagus: a prospective study of 170 patients followed 4.8years. Am J Gastroenterol; 1997, 92: 212-215.
Weston AFI Kampotich PT, Cherian R. Dixon A, Topalosvkl M. Prospective long-term endoscopic and histological follow-up of the short Barrett's esophagus: comparision with transitional long segment Barrett's esophagus. Am J Gastroenterol; 1997,92:407-413. Hackelsberger A, Gunther T, Schultze y, Manes G, Dominguez-Muñoz JE, Roessner A, Malfertheiner FI Intestinal metaplasia of the gastro-oesophageal junction: Helicobacter Pylori gastritis or gastro-oesophageal reflux disease?. Gut; 1998,43: 17-21.
Morales TG, Camargo E, Bhattacharyya A. Samplhie RE. Longterm follow-up of the intestinal metaplasia of the gastric cardia. Am 3 gastroenterol: 2000, 95: 1677-1680.
Ormsby AH, Goldblum JR, Rice TW, Richter JE, Faik GW, Vaezi MF'. Gramlich TL. The sensitivity and especificity of histologic features in the diagnostic of Barrett's esophagus on ioutine encloscopic biopsyspccimens (abstr). Ani J Cin Pathol; 1999, 112:A533.
Petras RE, Sivak MV, Rice TW. Barrett's esophagus: a review of the pathologist's role in diagnosis management.. Pathol Annu: 1991, 26: 1-32.
Ormsby AH, Goldblum JR, Rice TW, Richter JE, Falk GW, Vaezi MF, Gramlich TL. Cytokeratin subsets can reliably distinguish Barrett's esophagus from intestinal metaplasia of the stomach. Hum Pathol; 1999, 30: 288-294.
Ormsby AH, Vaezi MF, Richter JE, Goldblum JR, Rice TW, JE, Faik GW, Gramlich TL. Cytokeratin immunoreactivitv patterns in the diagnosis of short-segment Barrett's esophagus. Gastroenterology; 2000, 119: 683-690.
Blot Wd. Dhillon AP Frauineni-JF J. Continuing climb in rates of esophageal adenocarcinorna: an update. JAMA: 1993, 270: 1320.
Haggitt RC, Tryzelaar J, Ellis FI-1. Coicher H. Adenocarcinoma acomplicating columnar epithelial-linecl (Barrett's) esophagus. Ami Clin Pathol; 1978, 70:1-5.
Hamilton ST, Smith RR. The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett's esophagus. Am J Clin Pathol; 1987, 87: 301-312.
Caineron Ad, Lomboy CT, Pera M. Carpenter HA. Adenocarcinoma of the esophagogasl nc j unction and Barrett's esophagus. Gastroenterology; 1995, 109: 1541-1546.
Sharma P Weston AP Morales T. Relative risk of dysplasia for patients with intestinal metaplasia in the distal oesophagus and in the gastric cardia. Gut; 2000, 46: 9-13.
MoIl R, Lowe A, Laufer J. Cytokeratin 20 in human carcinomas: a new histodiagnostic macker cletected by monoclonal antibodies. Am 3 Pathol: 1992, 140: 427-447.
Van Niekerk CC, dap PHK. Raemakers FCS. hnmnuiiohistochemical demonstration of keratmn 7 in routinely fixed paraffin .emhedclecl human tissues. dPathol 1991: 165:145-152.
Glickman JN, Wang H. Das KM, Goyal RK, Spechler S, Antonioli D, Odze RD. Phenotype of Barrett's esophagus and intestinal metaplasia of the distal esophagus and gastroesophageal j u nction. An immunohistochemical study of cytokeratins 7 and 20. Das-1 and 45M1. Am 3 Surg Pathol; 2001, 25: 87-94.
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