Cytokeratin 7 & 20 staining patterns in patients with cardia intestinal metaplasia associated with either Barrett's esophagus or H. pylori

CONTEXT: Barrett's esophagus is characterized by the presence of goblet cells. However, when alcian-blue is utilized, another type of cells, called columnar blue cells, is frequently present in the distal esophagus of patients with endoscopic evidence of Barrett's esophagus. Cytokeratin 7 and 20 immunoreactivity has been previously studied in areas of intestinal metaplasia at the esophagogastric junction. However, the expression of these cytokeratins in columnar blue cells has not been characterized. OBJECTIVE: To compare the expression of cytokeratin 7 and 20 in goblet cells and columnar blue cells in patients with endoscopic evidence of Barrett's esophagus. METHODS: Biopsies from 86 patients with endoscopic evidence of Barrett's esophagus were evaluated. The biopsies were stained for cytokeratin 7 and 20. RESULTS: Goblet cells were present in 75 cases and columnar blue cells in 50 cases. Overall, cytokeratin 7 expression was similar in goblet cells and columnar blue cells (P = 0.25), while cytokeratin 20 was more common in goblet cells (P <0.001). In individuals with both cell types, however, cytokeratin 7 staining was the same in goblet and columnar blue cells in 95% of the cases, and cytokeratin 20 staining was the same in 77%. CONCLUSION: Goblet cells and columnar blue cells have similar immunohistochemical staining patterns for cytokeratins 7 and 20 in patients with endoscopic evidence of Barrett's esophagus.

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Short segment Barrett's esophagus and distal gastric intestinal metaplasia

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032006000200011 ◽

2006 ◽

Vol 43 (2) ◽

pp. 117-120

Author(s):

Judite Dietz ◽

Sílvia Chaves-e-Silva ◽

Luíse Meurer ◽

Setsuo Sekine ◽

Andréa Ribeiro de Souza ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Intestinal Metaplasia ◽

Barrett’S Esophagus ◽

Reflux Disease ◽

Barrett's Esophagus ◽

Short Segment ◽

Disease Symptoms ◽

Gastric Intestinal Metaplasia ◽

H Pylori

BACKGROUND: Short segment Barrett's esophagus is defined by the presence of <3 cm of columnar-appearing mucosa in the distal esophagus with intestinal metaplasia on histophatological examination. Barrett's esophagus is a risk factor to develop adenocarcinoma of the esophagus. While Barrett's esophagus develops as a result of chronic gastroesophageal reflux disease, intestinal metaplasia in the gastric cardia is a consequence of chronic Helicobacter pylori infection and is associated with distal gastric intestinal metaplasia. It can be difficult to determine whether short-segment columnar epithelium with intestinal metaplasia are lining the esophagus (a condition called short segment Barrett's esophagus) or the proximal stomach (a condition called intestinal metaplasia of the gastric cardia). AIMS: To study the association of short segment Barrett's esophagus (length <3 cm) with gastric intestinal metaplasia (antrum or body) and infection by H. pylori. PATIENTS AND METHODS: Eight-nine patients with short segment columnar-appearing mucosa in the esophagus, length <3 cm, were studied. Symptoms of gastroesophageal reflux disease were recorded. Biopsies were obtained immediately below the squamous-columnar lining, from gastric antrum and gastric corpus for investigation of intestinal metaplasia and H. pylori. RESULTS: Forty-two from 89 (47.2%) patients were diagnosed with esophageal intestinal metaplasia by histopathology. The mean-age was significantly higher in the group with esophageal intestinal metaplasia. The two groups were similar in terms of gender (male: female), gastroesophageal reflux disease symptoms and H. pylori infection. Gastric intestinal metaplasia (antrum or body) was diagnosed in 21 from 42 (50.0%) patients in the group with esophageal intestinal metaplasia and 7 from 47 (14.9%) patients in the group with esophageal columnar appearing mucosa but without intestinal metaplasia. CONCLUSION: Intestinal metaplasia is a frequent finding in patients with <3 cm of columnar-appearing mucosa in the distal esophagus. In the present study, short segment intestinal metaplasia in the esophagus is associated with distal gastric intestinal metaplasia. Gastroesophageal reflux disease symptoms and H. pylori infection did not differ among the two groups studied.

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The impact of Helicobacter pylori on the presence of Barrett's esophagus in Azerbaijan, a high-prevalence area of infection

Diseases of the Esophagus ◽

10.1093/dote/doz053 ◽

2019 ◽

Vol 32 (11) ◽

Cited By ~ 2

Author(s):

S Aghayeva ◽

K C Mara ◽

D A Katzka

Keyword(s):

Helicobacter Pylori ◽

Intestinal Metaplasia ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Erosive Esophagitis ◽

Control Group ◽

Significant Difference ◽

High Prevalence ◽

H Pylori ◽

The Impact

SUMMARY There is a strong evidence that Helicobacter pylori infection is inversely associated with Barrett's esophagus. In a high-prevalence region of H. pylori, low rates of esophageal cancer and its precursor BE may indicate its preventive effect. The aim of this study is to determine the impact of H. pylori on characteristics of Barrett's esophagus. A total of 3317 outpatient upper endoscopy reports from 2013 to 2015 from an urban center in Azerbaijan from all patients with dyspepsia were retrospectively analyzed for patients with Barrett's esophagus. This was matched in a 1:2 ratio to age and gender matched control patients without Barrett's esophagus. The prevalence of H. pylori on Barrett's esophagus and the randomly selected control group were compared. There were 83 patients with BE and 167 control group cases. Biopsy-proven BE was diagnosed in 83 patients: 39 (47%) females, with mean age 43.1 ± 13.3 years. Of these, 13 (15.7%) had long segment and 70 (84.3%) had short segment Barrett's esophagus. A control group included 167 patients: 78 (46.7%) females, with mean age (45.8 ± 13.9). All patients were Caucasians. The rates of gastric inflammation, the presence of atrophy, and intestinal metaplasia in gastric specimens did not differ in patients versus controls. The prevalence of H. pylori was determined as 63.2% in male and 61.5 in female groups (odd ratio (OR) = 0.99 95%CI 0.97, 1.01; P = 0.22). Inflammation of gastric mucosa was strongly associated with the infection (67% vs. 33%; OR = 4.46 95% CI: 2.01, 9.92, P < 0.001). Atrophy was noted in majority of H. pylori-positive cases (OR = 1.43, 95% CI: 0.36, 5.65; P = 0.61). Gastric intestinal metaplasia was observed in 55.6% of H. pylori-positive patients and in 44.4% of negative individuals (OR = 0.74, 95% CI: 0.28, 1.94; P = 0.54). There was not a significant difference in the prevalence of HP in BE and control groups; 63.9% were positive for infection in BE cases and 61.7% of controls (OR = 1.10, 95% CI: 0.64, 1.90; P = 0.74). We found that neither presence of erosive esophagitis, length of BE nor dysplasia (45.5% of H. pylori-positive group, whereas 54.5%) was associated with the presence of the H. pylori infection (Table 1). In a predominantly Caucasian nation with a high prevalence of H. pylori gastritis, the presence of H. pylori was not inversely associated with the presence of Barrett's esophagus. These data challenge the mechanistic implications of this association.

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Prevalence of barrett's esophagus, its relationship with chronic Helicobacter pylori-associated gastritis, atrophy and metaplasia of gastric mucosa

Клінічна та профілактична медицина ◽

10.31612/2616-4868.2(8).2019.09 ◽

2019 ◽

Vol 2 (8) ◽

pp. 77-89

Author(s):

T.V. Serha ◽

O.G. Kuryk ◽

V.A. Yakovenko ◽

G.A. Solovyova ◽

R.P. Tkachenko

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Intestinal Metaplasia ◽

Barrett’S Esophagus ◽

Histological Examination ◽

Barrett's Esophagus ◽

Gastric Epithelium ◽

Gastric Type ◽

H Pylori ◽

Epithelial Metaplasia

The aim - to identify the frequency of Helicobacter pylori infection, atrophic and metaplastic changes in the gastric mucosa in patients with Barrett's esophagus. Materials and methods. A retrospective study of 7392 cases of complex esophagogastroscopy with a biopsy of the epithelium of the mucous membrane of the esophagus and stomach, followed by a morphological study, was conducted on the basis of the Medical Centre “Oberig” clinic for the period 2010-2018. Statistical data was performed using the MedStat package. To assess the prevalence of changes in the esophagus and stomach, a 95% confidence interval was calculated using the Fisher angular transformation method. The probability of differences between group averages and relative values was determined using the method of parametric statistics by calculating the t-Student criterion. The difference between the average values was considered significant at p <0.05. To compare the frequencies in different groups, the Pearson chi-square test was used. Results. Endoscopically cylindrical columnar metaplasia of the esophagus epithelium was detected in 2994 patients (40.5% CI 39.4% -41.6% at a significance level of p = 0.05). In a histological examination, esophageal epithelial metaplasia was confirmed in 2910 patients (39.4% CI 38.3%-40.5%). 876 cases of gastric-type esophagus epithelial metaplasia were diagnosed (30.1%, CI 28.4-31.5%); 2034 cases of intestinal type metaplasia (69.9%, CI 68.2-71.6%). Histological examination of biopsy samples of the gastric mucosa in 5640 (76.3%, CI 75.3-77.3%) patients revealed atrophy of the gastric mucosa. In 2532 cases (34.3%, CI 33.2-35.3%), complete and incomplete intestinal metaplasia of the gastric epithelium was diagnosed. In 4524 (61.2%, CI 60.1-62.3%) patients, Helicobacter pylori was detected. In the presence of H. pylori, gastric esophageal epithelial metaplasia was detected in 510 of 3558 (14.3%, CI 13.2-15.5%, p = 0.05), intestinal metaplasia of the esophagus epithelium - in 966 of 4014 (24.1% CI 22.8 -25.4%, p = 0.05). Conclusion. Esophageal epithelial metaplasia is a common pathology, accounting for 39.4% among patients who underwent esophagogastroscopy. The presence of a strong connection between intestinal metaplasia of the epithelium of the esophagus and atrophy of the gastric mucosa with intestinal metaplasia of the epithelium of the stomach was found. Esophageal epithelial metaplasia is significantly less common with Helicobacter pylori gastritis, therefore the presence of H. pylori has a protective effect on the occurrence of esophageal epithelial metaplasia.

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