A renewed insight into Barrett's esophagus: Comparative histopathological analysis of esophageal columnar metaplasia

I. B. Nemeth, A. Rosztóczy, F. Izbéki, R. Róka, K. Gecse, F. Sukosd, T. Nyári, T. Wittmann, L. Tiszlavicz

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5 Citations (Scopus)

Abstract

Specialized intestinal metaplasia (SIM) is considered as a premalignant condition of the esophagus, but other types of esophageal metaplasia are commonly neglected. A standardized histopathological analysis was focused not only on SIM but also on the presence of metaplastic processes typical of additional glands. A morphological study using standardized histopathological tests was carried out between 2004 and 2007, with biopsies taken from esophageal mucosa of 826 consecutive patients. Mean age and male : female ratio of patients were 55.6 ± 14.7 and 1.1 : 1, respectively. Only 4.1% (n= 34) of all cases proved to have SIM. The remainder of the cases (n= 615; 74.4%) contained cardiac-fundic mucosa without SIM. Some samples exhibited superficial mucous glands, pancreatic acinar metaplasia (PAM), and ciliated metaplasia accounting for 24% (n= 198), 14.9% (n= 123), and 0.2% (n= 2), respectively. SIM was colocalized with superficial mucous glands (103/198 superficial mucous gland cases; P <0.001). Low-grade dysplasia (n= 51; 6.2%) and high-grade dysplasia (n= 9; 1.1%) were found mainly in SIM (37/51; 9/9; P= 0.071) with male preponderance (3 : 1 at low-grade and 2 : 1 at high-grade dysplasia). PAM was found mainly in cases without dysplasia (103 of 123 pancreatic metaplasias; P <0.001). SIM alone in the esophagus is rare, and its frequent association with cardiac mucosa-type metaplasia testifies to transition of mucinous-goblet cell through pseudogoblet cells. PAM rather indicates absence of dysplasia, but superficial mucous glands predicts that SIM follows dysplasia.

Original languageEnglish
Pages (from-to)395-402
Number of pages8
JournalDiseases of the Esophagus
Volume25
Issue number5
DOIs
Publication statusPublished - Jul 2012

Fingerprint

Barrett Esophagus
Metaplasia
Esophagus
Mucous Membrane
Goblet Cells

Keywords

  • Barrett's esophagus
  • Pancreatic acinar cell metaplasia
  • Specialized intestinal metaplasia
  • Superficial mucous gland

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "A renewed insight into Barrett's esophagus: Comparative histopathological analysis of esophageal columnar metaplasia",
abstract = "Specialized intestinal metaplasia (SIM) is considered as a premalignant condition of the esophagus, but other types of esophageal metaplasia are commonly neglected. A standardized histopathological analysis was focused not only on SIM but also on the presence of metaplastic processes typical of additional glands. A morphological study using standardized histopathological tests was carried out between 2004 and 2007, with biopsies taken from esophageal mucosa of 826 consecutive patients. Mean age and male : female ratio of patients were 55.6 ± 14.7 and 1.1 : 1, respectively. Only 4.1{\%} (n= 34) of all cases proved to have SIM. The remainder of the cases (n= 615; 74.4{\%}) contained cardiac-fundic mucosa without SIM. Some samples exhibited superficial mucous glands, pancreatic acinar metaplasia (PAM), and ciliated metaplasia accounting for 24{\%} (n= 198), 14.9{\%} (n= 123), and 0.2{\%} (n= 2), respectively. SIM was colocalized with superficial mucous glands (103/198 superficial mucous gland cases; P <0.001). Low-grade dysplasia (n= 51; 6.2{\%}) and high-grade dysplasia (n= 9; 1.1{\%}) were found mainly in SIM (37/51; 9/9; P= 0.071) with male preponderance (3 : 1 at low-grade and 2 : 1 at high-grade dysplasia). PAM was found mainly in cases without dysplasia (103 of 123 pancreatic metaplasias; P <0.001). SIM alone in the esophagus is rare, and its frequent association with cardiac mucosa-type metaplasia testifies to transition of mucinous-goblet cell through pseudogoblet cells. PAM rather indicates absence of dysplasia, but superficial mucous glands predicts that SIM follows dysplasia.",
keywords = "Barrett's esophagus, Pancreatic acinar cell metaplasia, Specialized intestinal metaplasia, Superficial mucous gland",
author = "Nemeth, {I. B.} and A. Roszt{\'o}czy and F. Izb{\'e}ki and R. R{\'o}ka and K. Gecse and F. Sukosd and T. Ny{\'a}ri and T. Wittmann and L. Tiszlavicz",
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T2 - Comparative histopathological analysis of esophageal columnar metaplasia

AU - Nemeth, I. B.

AU - Rosztóczy, A.

AU - Izbéki, F.

AU - Róka, R.

AU - Gecse, K.

AU - Sukosd, F.

AU - Nyári, T.

AU - Wittmann, T.

AU - Tiszlavicz, L.

PY - 2012/7

Y1 - 2012/7

N2 - Specialized intestinal metaplasia (SIM) is considered as a premalignant condition of the esophagus, but other types of esophageal metaplasia are commonly neglected. A standardized histopathological analysis was focused not only on SIM but also on the presence of metaplastic processes typical of additional glands. A morphological study using standardized histopathological tests was carried out between 2004 and 2007, with biopsies taken from esophageal mucosa of 826 consecutive patients. Mean age and male : female ratio of patients were 55.6 ± 14.7 and 1.1 : 1, respectively. Only 4.1% (n= 34) of all cases proved to have SIM. The remainder of the cases (n= 615; 74.4%) contained cardiac-fundic mucosa without SIM. Some samples exhibited superficial mucous glands, pancreatic acinar metaplasia (PAM), and ciliated metaplasia accounting for 24% (n= 198), 14.9% (n= 123), and 0.2% (n= 2), respectively. SIM was colocalized with superficial mucous glands (103/198 superficial mucous gland cases; P <0.001). Low-grade dysplasia (n= 51; 6.2%) and high-grade dysplasia (n= 9; 1.1%) were found mainly in SIM (37/51; 9/9; P= 0.071) with male preponderance (3 : 1 at low-grade and 2 : 1 at high-grade dysplasia). PAM was found mainly in cases without dysplasia (103 of 123 pancreatic metaplasias; P <0.001). SIM alone in the esophagus is rare, and its frequent association with cardiac mucosa-type metaplasia testifies to transition of mucinous-goblet cell through pseudogoblet cells. PAM rather indicates absence of dysplasia, but superficial mucous glands predicts that SIM follows dysplasia.

AB - Specialized intestinal metaplasia (SIM) is considered as a premalignant condition of the esophagus, but other types of esophageal metaplasia are commonly neglected. A standardized histopathological analysis was focused not only on SIM but also on the presence of metaplastic processes typical of additional glands. A morphological study using standardized histopathological tests was carried out between 2004 and 2007, with biopsies taken from esophageal mucosa of 826 consecutive patients. Mean age and male : female ratio of patients were 55.6 ± 14.7 and 1.1 : 1, respectively. Only 4.1% (n= 34) of all cases proved to have SIM. The remainder of the cases (n= 615; 74.4%) contained cardiac-fundic mucosa without SIM. Some samples exhibited superficial mucous glands, pancreatic acinar metaplasia (PAM), and ciliated metaplasia accounting for 24% (n= 198), 14.9% (n= 123), and 0.2% (n= 2), respectively. SIM was colocalized with superficial mucous glands (103/198 superficial mucous gland cases; P <0.001). Low-grade dysplasia (n= 51; 6.2%) and high-grade dysplasia (n= 9; 1.1%) were found mainly in SIM (37/51; 9/9; P= 0.071) with male preponderance (3 : 1 at low-grade and 2 : 1 at high-grade dysplasia). PAM was found mainly in cases without dysplasia (103 of 123 pancreatic metaplasias; P <0.001). SIM alone in the esophagus is rare, and its frequent association with cardiac mucosa-type metaplasia testifies to transition of mucinous-goblet cell through pseudogoblet cells. PAM rather indicates absence of dysplasia, but superficial mucous glands predicts that SIM follows dysplasia.

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