Alimentary TractCytokeratin immunoreactivity patterns in the diagnosis of short-segment Barrett's esophagus☆
Section snippets
Patient selection
Patients with suspected short-segment Barrett's esophagus, long-segment Barrett's esophagus, and gastric intestinal metaplasia were identified from the files of The Cleveland Clinic Foundation spanning a 3-year period (1996–1998). Short-segment Barrett's esophagus was defined endoscopically as tongues and/or circumferential columnar-appearing mucosa <3 cm above the proximal margin of the gastric folds, with intestinal metaplasia identified on biopsy specimens obtained from the area of suspected
Cohort characteristics, exclusions, and interobserver agreement
A total of 127 patients were evaluated. Biopsy specimens from 7 patients were considered inadequate because of poor orientation and were excluded from the evaluation. Interobserver agreement between the 2 gastrointestinal pathologists in the remaining 120 cases was excellent (κ = 0.95), with only 2 discrepant cases, leaving a total 118 patients for evaluation.
Overall, 49 patients with long-segment Barrett's esophagus, 43 patients with suspected short-segment Barrett's esophagus, and 26 patients
Discussion
Barrett's esophagus is the single most important risk factor for the development of esophageal dysplasia and carcinoma25, 26, 27, 28; consequently, strategies to prevent esophageal adenocarcinoma have focused on early recognition of specialized columnar mucosa with subsequent regular endoscopic surveillance. Historically, Barrett's esophagus referred to the presence of long areas of esophageal columnar mucosa (>3 cm proximal to the esophagogastric junction), now known as long-segment Barrett's
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Epithelial-Stromal Interactions in Barrett's Esophagus Modeled in Human Organ Chips
2023, Gastro Hep AdvancesSome observations on Barrett esophagus and associated dysplasia
2018, Annals of Diagnostic PathologyCitation Excerpt :This topic was comprehensively reviewed by Panarelli and Yantiss, who concluded that neither histochemical nor immunohistochemical stains add value over H&E stains since they produce false positives [10]. In the past, the concept of using CK7/CK20 stains to separate esophageal intestinal metaplasia from gastric cardiac intestinal metaplasia was introduced by Ormsby et al. [11,12]. These authors studied long-segment Barrett esophagus cases (>3 cm) and noted superficial and deep CK7 immunoreactivity in the intestinalized mucosa, with only superficial CK20 staining in the intestinalized zones.
Gastric foveolar dysplasia: a survey of reporting habits and diagnostic criteria
2017, PathologyCitation Excerpt :However, none of these criteria have been systematically applied to show the degree of reproducibility in foveolar-type dysplasia of the oesophagus and the stomach. Previous studies on dysplasia (adenomatous-type) in Barrett's oesophagus have shown imperfect inter-observer reproducibility with lack of reproducibility especially prevalent at the low end of the spectrum with ‘indefinite’ and ‘low-grade’ categories.1,6,7 On the other hand, a recent study showed an over-diagnosis of high-grade dysplasia in Barrett's oesophagus with confirmed high-grade dysplasia in only 51% of the cases reviewed.8
Pathophysiology of the Columnar-Lined Esophagus
2012, Shackelford's Surgery of the Alimentary Tract: Volume 1-2, Seventh EditionIncidence and physiopathology of high-grade dysplasia in Barrett's esophagus
2011, Presse MedicaleMicroscopic esophagitis and Barrett's esophagus: The histology report
2011, Digestive and Liver Disease
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Address requests for reprints to: Terry L. Gramlich, M.D., The Cleveland Clinic Foundation, 9500 Euclid Avenue L25, Cleveland, Ohio 44195. e-mail: [email protected]; fax: (216) 445-6967.