Application And Significance Of HTERC Gene Amplification And Series Antibody Expression In Pathologic Diagnosis Of Barrett’s Esophagus

[Background and Purpose]Esophageal adenocarcinoma (EA) has shown a fast rise in incidence in Western countries in thepast decades. The incidence of EA also increased gradually and has been paid more and moreattention. Barrett’s esophagus (BE), the premalignant lesion of EA, confers a significantincreased risk for development of esophageal adenocarcinoma. The key to reduce the morbidityand the mortality of EA is early diagnosis of BE. Clinic studies found that despite endoscopy haseffective indentifying the anatomy of esophagogastric junction; this technology also has somelimitations; and the resulting is another important diagnostic tool—microscope cannot distinctbetween BE with intestinal metaplasia (IM) and IM of proximal gastric mucosa. The purpose ofthis study is to discern BE from proximal gastric IM by immunohistochemistry and fluorescencein situ hybridization(FISH) and provide some thought for the pathologic diagnosis of BE so as toprevent EA.[Methods and materials]One hundred thirty-five cases of patient who had been suspected and diagnosed with BE inBeijing General Hospital from 2002 to 2010 were enrolled in this study. Endoscopic biopsies ofgastric mucosa obtained at gastroesophageal junction from these patients were made. Wediagnosed 38 of them as BE, while 44of others as proximal gastric mucosa IM and collectedtheir clinical and histopathological data. Histopathological examination andimmunohistochemistry as well as fluorescent in situ hybridization were preformed . Thus we canmake a distinction between BE and proximal gastric mucosa IM by observing theexpression of CK7/CK20, CK4, CK8, S100p, MUC6, COX2, Bcl-2 and gene amplification ofhTERC.[Results]The expression of CK7, CK20, MUC6, of COX-2, Bcl-2 between proximal gastric mucosa IM patients and BE IM had no statistically difference (P>0.05) while the positive expression ofS100p in two groups was statistically different (P<0.05). The expression of CK7 was correlatedpositively with the expression of CK4, and CK8 in BE cases (P<0.05), while no correlation wasfound in proximal gastric mucosa IM cases. The comparison of gene expression of hTERCbetween BE group and proximal gastric mucosa IM group by FISH test showed that the rate ofpositive expression in BE group was 57.9%, while the rate in proximal gastric mucosa IMgroup was 13.6%, the differences between them were statistically significant (P<0.05).[Conclusion]1. The role of CK7 and CK20 in identification between BE and proximal gastric mucosaIM is uncertain.2. Co-expression of CK7,CK4 and CK8 supports the diagnosis of BE, and has thedifferential diagnostic value.3. S100p may be a marker which can distinguish between BE and proximal gastric mucosaIM.4. Gene amplification of hTERC may help diagnose BE even have an important role inprogression to EA from BE.