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Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study.

Szachnowicz S, Cecconello I, Ribeiro U, Iriya K, El Ibrahim R, Takeda FR, Corbett CE, Vaz Safatle-Ribeiro A - World J Surg Oncol (2009)

Bottom Line: Two tumors did not express MUC2 or MUC5AC proteins.The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

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Affiliation: Department of Gastroenterology, Digestive Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil. sergioszac@gmail.com

ABSTRACT

Background: Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE) may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification.

Methods: Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies.

Results: Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old). The tumor size had a mean of 4.7 +/- 2.3 cm, and the extension of BE had a mean of 7.7 +/- 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive) and intestinal type in 4/13 (MUC2 positive). Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.

Conclusion: Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

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MUC2 immunoexpression in intestinal type adenocarcinoma arising in Barrett's esophagus. Immunohistochemical staining of MUC2 for adenocarcinoma (original magnification × 400)
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Figure 3: MUC2 immunoexpression in intestinal type adenocarcinoma arising in Barrett's esophagus. Immunohistochemical staining of MUC2 for adenocarcinoma (original magnification × 400)

Mentions: According to the pattern of mucin expression, four tumors were classified as MUC2 positive (Figure 3) indicating an intestinal type of tumor differentiation, while seven were MUC5AC positive tumors (Figure 4), indicating a gastric type of tumor differentiation. Two undifferentiated tumors had no mucin expression and therefore could not be classified.


Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study.

Szachnowicz S, Cecconello I, Ribeiro U, Iriya K, El Ibrahim R, Takeda FR, Corbett CE, Vaz Safatle-Ribeiro A - World J Surg Oncol (2009)

MUC2 immunoexpression in intestinal type adenocarcinoma arising in Barrett's esophagus. Immunohistochemical staining of MUC2 for adenocarcinoma (original magnification × 400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2662840&req=5

Figure 3: MUC2 immunoexpression in intestinal type adenocarcinoma arising in Barrett's esophagus. Immunohistochemical staining of MUC2 for adenocarcinoma (original magnification × 400)
Mentions: According to the pattern of mucin expression, four tumors were classified as MUC2 positive (Figure 3) indicating an intestinal type of tumor differentiation, while seven were MUC5AC positive tumors (Figure 4), indicating a gastric type of tumor differentiation. Two undifferentiated tumors had no mucin expression and therefore could not be classified.

Bottom Line: Two tumors did not express MUC2 or MUC5AC proteins.The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology, Digestive Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil. sergioszac@gmail.com

ABSTRACT

Background: Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE) may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification.

Methods: Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies.

Results: Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old). The tumor size had a mean of 4.7 +/- 2.3 cm, and the extension of BE had a mean of 7.7 +/- 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive) and intestinal type in 4/13 (MUC2 positive). Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.

Conclusion: Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

Show MeSH
Related in: MedlinePlus