Expression of CDX2 and MUC2 in Barrett's mucosa

Expression of CDX2 and MUC2 in Barrett's mucosa

Barrett's mucosa is a risk factor for esophageal adenocarcinoma and should be detected at an early stage. It is defined by the presence of columnar epithelium with goblet cells in the lower esophagus, but histologic diagnosis can be uncertain in the absence of distinct goblet cells. We investig...

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Bibliographic Details
Published in:Pathology, research and practice Vol. 201; no. 8; pp. 573 - 577
Main Authors: Steininger, Helmuth, Pfofe, Denis A., Müller, Henning, Haag-Sunjic, Gabriele, Fratianu, Veronica
Format: Journal Article
Language:English
Published: Germany Elsevier GmbH 01-01-2005
Subjects:
Aged
Alcian Blue
Alcian blue (pH 2,5)/PAS
Barrett Esophagus - metabolism
Barrett Esophagus - pathology
Barrett's mucosa
Biopsy
CDX2
CDX2 Transcription Factor
Cell Nucleus - metabolism
Cell Nucleus - pathology
Coloring Agents
Cytoplasm - metabolism
Cytoplasm - pathology
Early Diagnosis
Endoscopy, Gastrointestinal
Esophagus - metabolism
Esophagus - pathology
Female
Homeodomain Proteins - metabolism
Humans
Immunohistochemistry
Male
Middle Aged
MUC2
Mucin-2
Mucins - metabolism
Mucous Membrane - metabolism
Mucous Membrane - pathology
Periodic Acid-Schiff Reaction
Precursor lesion
Alcian blue (pH 2,5)/PAS
MUC2
Precursor lesion
Barrett's mucosa
CDX2
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Summary:Barrett's mucosa is a risk factor for esophageal adenocarcinoma and should be detected at an early stage. It is defined by the presence of columnar epithelium with goblet cells in the lower esophagus, but histologic diagnosis can be uncertain in the absence of distinct goblet cells. We investigated 55 biopsies from 48 patients with endoscopically plain Barrett's esophagus and performed immunohistochemistry for CDX2 and MUC2. In addition, alcian blue (pH 2,5)/PAS staining was done. In histologically unequivocal Barrett's mucosa, nuclear expression of CDX2 in goblet cells and many columnar cells, as well as cytoplasmic positivity for MUC2 in goblet cells, could be observed. Alcian blue (pH 2,5)/PAS stained acidic mucins in goblet cells and in some non-goblet columnar cells. In six cases, no definite Barrett's mucosa was present, and no expression of MUC2 could be observed. In these biopsies, there was granular cytoplasmic and /or focal nuclear staining for CDX2 in non-goblet columnar epithelial cells, indicating their intestinal differentiation. We suggest that this peculiar mucosa is the precursor of unequivocal Barrett's mucosa and would designate it early Barrett's mucosa. Alcian blue for acidic mucins is inconsistent in this epithelium and does not reliably indicate early intestinal differentiation.
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ISSN:0344-0338
1618-0631
DOI:10.1016/j.prp.2005.03.010