Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2002-12-10
pubmed:abstractText
Barrett's metaplasia is recognized by specialized columnar epithelium on the distal esophagus. The events involved in the transformation from squamous to Barrett's epithelium remain unclear. The present study describes the characteristics observed during the recurrence of four cases of columnar-lined esophagus. Red velvet, gastric-like, esophageal mucosa was observed to develop above the anastomosis during follow-up of four patients submitted to surgery for esophageal and junctional adenocarcinoma. The areas of recurrence were associated with reflux symptoms and inflammation, with ulceration in two cases. Biopsies from the upper gastrointestinal endoscopies were examined histologically using periodic acid-Schiff/Alcian blue to detect acid mucins and a monoclonal antibody raised against the enterocytic enzyme sucrase-isomaltase. In all cases the recurrent columnar-lined segments displayed intestinal features recognized morphologically, histochemically, and/or immunohistochemically. There was no evidence of specialized columnar epithelium in three cases. The fourth patient developed specialized columnar epithelium during the tenth year of surveillance. The presence of AB-positive columnar cells was a frequent and early event. Columnar cells with unequivocal apical sucrase-isomaltase were observed only in association with specialized columnar epithelium. Four conclusions were reached: that the development of columnar-lined mucosa without specialized columnar epithelium may be the earliest event in Barrett's metaplasia; that histochemistry is a useful method of recognizing a population with cryptic intestinal features; that acid mucin secretion precedes the production of enterocytic enzymes by columnar cells; and that a cell population with enterocytic differentiation, as assessed by sucrase-isomaltase expression, is associated with the development of specialized columnar epithelium. These characteristics of Barrett's esophagus development are clinically relevant as they suggest that patients with columnar-lined esophagus without specialized columnar epithelium may acquire 'true' intestinal phenotype, justifying them being considered as high- risk patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1120-8694
pubmed:author
pubmed:issnType
Print
pubmed:volume
15
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
282-6
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12472472-Adenocarcinoma, pubmed-meshheading:12472472-Aged, pubmed-meshheading:12472472-Aged, 80 and over, pubmed-meshheading:12472472-Barrett Esophagus, pubmed-meshheading:12472472-Cell Differentiation, pubmed-meshheading:12472472-Enterocytes, pubmed-meshheading:12472472-Epithelium, pubmed-meshheading:12472472-Esophageal Neoplasms, pubmed-meshheading:12472472-Esophagectomy, pubmed-meshheading:12472472-Esophagogastric Junction, pubmed-meshheading:12472472-Esophagus, pubmed-meshheading:12472472-Female, pubmed-meshheading:12472472-Gastrectomy, pubmed-meshheading:12472472-Humans, pubmed-meshheading:12472472-Immunohistochemistry, pubmed-meshheading:12472472-Male, pubmed-meshheading:12472472-Middle Aged, pubmed-meshheading:12472472-Mucous Membrane, pubmed-meshheading:12472472-Phenotype
pubmed:year
2002
pubmed:articleTitle
Recurrent columnar-lined esophageal segments--study of the phenotypic characteristics using intestinal markers.
pubmed:affiliation
Department of Pathology, Instituto Português de Oncologia de Francisco Gentil, Lisbon, Portugal. apat@ipolisboa.min-saude.pt
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't