Thesis or Dissertation Intestinal metaplasia in Barrett's oesophagus may be an epiphenomenon rather than a pre-neoplastic condition, and CDX2-positive cardiac-type epithelium is associated with minute Barrett's tumour

Watanabe, Gen  ,  渡邉, 玄

pp.1 - 14 , 2015-03-23 , 新潟大学
学位の種類: 博士(医学). 報告番号: 乙第2188号. 学位記番号: 新大博(医)乙第1777号. 学位授与年月日: 平成27年3月23日
Histopathology. 2015, 66(2), 201-214.
Aims: Although intestinal-type epithelium in Barrett’s oesophagus has been traditionally recognised as having a distinct malignant potential, whether this also holds true for cardiac-type epithelium remains controversial. The aim of this study was to identify highly associated type of epithelium with Barrett’s tumour. Methods and results: We analysed tumours and the corresponding background mucosa with special regard to tumour size in 40 cases of superficial Barrett’s tumour by using mmunohistochemical staining for CDX2, CD10, MUC2, MUC5AC, and MUC6. Intestinal metaplasia in tumour-adjacent mucosa was not associated with tumour size, but was significantly correlated with the extent of Barrett’s oesophagus (P < 0.001). Majority (69.2%, 9/13) of small tumours (≤10 mm in size) had no intestinal metaplasia in adjacent non-neoplastic mucosae. Minute (≤5 mm) tumours were significantly associated with gastric immunophenotype (P < 0.001). Purely gastric-immunophenotype tumour cells expressed CDX2, and cardiac-type epithelium adjacent to small tumours also displayed low-level CDX2 expression. Conclusions: Our data suggest that intestinal metaplasia in Barrett’s oesophagus is an epiphenomenon rather than a pre-neoplastic condition and that CDX2-positive cardiac-type epithelium is highly associated with minute Barrett’s tumour. Further prospective studies are needed to evaluate the risk of malignancy of cardiac-type epithelium with regard to sub-morphological intestinalisation.

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