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( Jan Gregar ),( Pavla Luzna ),( Jiri Ehrmann Jr ),( Vlastimil Prochazka ),( Premek Falt ),( Stepan Suchanek ),( Josef Srovnal ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Barrett`s esophagus (BE) is premalignant condition. Sequence of histological changes from intestinal metaplasia (IM) through low-grade dysplasia (LG) up to high-grade dysplasia and adenocarcinoma. Endoscopy and histopathology assessment is "gold standard" for diagnosis. But immunohistochemistry can be helpful for stratify-cation and assessment of risk of dysplasia/malignancy. Methods: The aim of the study was to investigate the role and the diagnostic potential of the immunohistochemistry in the disease progression. BE was inspected by endoscopy (narrow band imaging and zoom) and biopsies from all suspicious lesions were obtained for histopathological assessment (50 patients, diagnosed in the last 3 years). 25 patients with non-dysplastic BE (IM) and 25 patients with low-grade dysplasia BE (LG). Bioptic samples (50 patients) were used for indirect immunohistochemical labelling and analysis of expression of proteins playing an important role during BE progression (CDX2, MUC2, H2AX and p53). Expression of selected proteins was assessed semiquantitatively by “histoscore“(H score), which is the result of intensity of staining (0 = negative, 1 = weakly visible intensity, 2 = ligh brown intensity, 3 = dark brown intensity of staining) multiplied by percentage of positive cells. Results: Immunohistochemical detection of expression of selected proteins showed the rising histoscore of all selected proteins in BE with LG dysplasia against non-dysplastic IM BE: CDX (16.7% vs. 33.3%), MUC2 (6.3% vs. 36.4%), H2AX (25.9% vs. 44.4%) and p53 (75.0% vs. 89.6%). Statistical significance was found in CDX, MUC2 and H2AX proteins. Conclusions: Immunohistochemistry of selected proteins could be helpful method how to estimate progression of BE, and how to select patients with risk of dysplastic changes in BE.