Original ContributionsExpression of apoptosis-related proteins in Barrett's metaplasia-dysplasia-carcinoma sequence: A switch to a more resistant phenotype*,**
Section snippets
Patient selection and tissue collection
We studied tissue samples taken from patients who participated in an endoscopy surveillance program between January 1998 and December 2000 at the University Hospital Groningen. All patients used omeprazole at the time of endoscopy. Samples were stained with hematoxylin and eosin and periodic acid–Schiff. Standard histologic examination was performed on these stained samples, with attention given to the type of metaplasia, presence and degree of inflammation and dysplasia, and presence of
Patients
Samples from 28 patients (20 male, 8 female) were included. The age range of these patients was 31 to 86 years (mean, 58). Six samples contained gastric metaplasia (GM), 21 contained intestinal metaplasia (IM), 8 contained indefinite for and low-grade dysplasia, and 6 contained high-grade dysplasia and carcinoma (CA). The adenocarcinoma group was expanded with archival resection material from 4 patients with CLE-associated adenocarcinoma.
Immunohistochemistry (tables 2 and 3)
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Discussion
In CLE, iNOS is highly expressed in IM and in 50% of samples containing dysplasia, but not in CLE-associated adenocarcinoma. All of our samples containing high-grade dysplasia were positive for iNOS, as reported by Wilson et al.21 However, in contrast to these authors, we did not observe iNOS expression in CLE-associated adenocarcinomas. Nitric oxide, the product of iNOS, is able to inhibit apoptosis in low concentrations, due in part to inhibition of caspase activity.13 In high concentrations,
Acknowledgements
We thank B. Hansen for her help with statistical analysis.
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Supported by an unrestricted grant from AstraZeneca.
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Address correspondence and reprint requests to C. J. van der Woude, MD, Department of Gastroenterology, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.