Expression of CDX2 and MUC2 in Barrett's mucosa

Steininger, H; Pfofe, Denis; Müller, Henning; Haag-Sunjic, Gabriele; Fratianu, Veronica

doi:10.1016/j.prp.2005.03.010

Cited by 27 publications

(26 citation statements)

References 27 publications

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“…[10][11][12][13][14][15][16][17] Nevertheless, it has been reported that the Barrett esophagus columnar mucosa is 'intestinalized' when examined by immunohistochemical markers of intestinal differentiation, even in the absence of histological evidence of intestinal metaplasia, that is, goblet cells. [18][19][20][21][22][23] Thus supporting the current American College of Gastroenterology guidelines, which require the presence of intestinal metaplasia for the diagnosis of Barrett esophagus. 24 Clinical experience has suggested the presence of two cyto-architectural patterns of Barrett esophagus dysplasia and the terms type 1 and type 2 or adenomatous and non adenomatous (also known as 'foveolar/hyperplastic') akin to gastric dysplasia, have been applied to these patterns.…”

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confidence: 53%

“…Rounded cells with vesicular nuclei and prominent nucleoli are the usual cytological features, whereas closely packed glands constitute the main architectural characteristic. 26 Notably, in a recent study of endoscopic biopsies, 18 Barrett esophagus patients with a non adenomatous pattern of dysplasia showed no significant differences regarding either flow cytometric abnormalities or progression to cancer compared with adenomatous dysplasia 29 Recent advances in mucin and other immunohistochemistry have enabled better characterization of premalignant conditions of the stomach and pancreas, and in both conditions, this subdivision has clinicopathological relevance. 27,[30][31][32] To date, no formal analysis of a possible similar division has been undertaken in the setting of Barrett esophagusrelated dysplasia.…”

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confidence: 99%

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Foveolar type dysplasia in Barrett esophagus

2010

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Adenocarcinoma of the lower esophagus and esophagogastric junction is increasing in incidence in Western countries. A metaplasia (Barrett esophagus)-dysplasia-carcinoma sequence induced by gastroesophageal reflux disease is established. Two patterns of Barrett dysplasias have been described-adenomatous (type 1) and non-adenomatous (type 2 or foveolar/hyperplastic type). Interestingly, little is known about non-adenomatous dysplasia. Esophagogastrectomy cases from 41 patients with glandular dysplasia with and without associated invasive adenocarcinoma of the lower esophagus were evaluated for expression of MUC2, MUC5AC, CDX2, villin, Ki67 and p53. Results were correlated with sub-classification of the dysplasia into morphologic patterns of adenomatous vs foveolar vs hybrid type. In addition, clinicopathological parameters including the presence and extent of background intestinal metaplasia were also evaluated. Foveolar type dysplasia was present in 46% of the cases and thus, was more common than adenomatous type or hybrid type (both B27%) dysplasia. Immunohistochemistry confirmed the histological stratification in all cases. Foveolar type dysplasia commonly expressed MUC5AC (Po0.12) but was consistently negative for markers of intestinal differentiation, MUC2, CDX2 and villin (all Po0.01). By contrast, adenomatous type dysplasia frequently displayed intestinal differentiation markers (all Po0.0001) Hybrid-type dysplasia was similar to adenomatous type dysplasia in showing expression of intestinal differentiation markers (Po0.01) and therefore could not be sustained as a separate category. In conclusion, our study provides evidence for a non intestinal pathway to neoplastic development in Barrett esophagus, that is, gastric metaplasia-foveolar dysplasia-adenocarcinoma.

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confidence: 53%

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confidence: 99%

Foveolar type dysplasia in Barrett esophagus

2010

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“…We demonstrate that FOXA2 is a target of Hh signaling in the embryonic mouse esophageal epithelium as well as in human Barrett's epithelial cells and esophageal squamous epithelial cells derived from patients with Barrett's esophagus. Moreover, we found that overexpression of FOXA2 in human esophageal squamous epithelial cells induces expression of MUC2 and AGR2 (an endoplasmic reticulum protein involved in MUC2 processing) (25,(30)(31)(32)(33). These studies suggest that the Hh target gene FOXA2 is involved in the pathogenesis of the specialized intestinal type of Barrett's metaplasia.…”

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confidence: 66%

Hedgehog signaling regulates FOXA2 in esophageal embryogenesis and Barrett’s metaplasia

Wang¹,

Tiwari

Kim

et al. 2014

J. Clin. Invest.

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“…Initially, CDX2 expression was found in large and small bowel [13], strongly and diffusely expressed in the nucleus of small and large intestinal epithelial cells, including absorptive cells, goblet cells, endocrine cells and Paneth cells. In pancreatic epithelium, however, CDX2 exhibits a focal expression [14].…”

Section: Introductionmentioning

confidence: 99%

“…In pancreatic epithelium, however, CDX2 exhibits a focal expression [14]. Esophageal and gastric epithelial cells do not express CDX2, although CDX2 expression has been observed in esophageal and gastric IM [13] [15]- [19].…”

Section: Introductionmentioning

confidence: 99%

CDX2 Overexpression in Barrett’s Esophagus and Esophageal Adenocarcinoma

Streher¹,

Campos²,

Mazzini³

et al. 2014

JCT

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Background: Patients with Barrett's esophagus have an increased risk of developing esophageal adenocarcinoma. Our purpose was to determine CDX2 expression in esophageal mucosa and establish a correlation between this marker and the progression of disease. Methods: We analyzed biopsies and surgical specimens from 150 patients who were divided into five groups according to histopathological diagnosis: G1, normal mucosa (n = 29); G2, esophagitis (n = 19); G3, columnar epithelium without intestinal metaplasia (n = 26); G4, Barrett's esophagus (n = 32), and G5, adenocarcinoma (n = 44). Immuno-histochemical determination of CDX2 expression was considered positive in the presence of nuclear staining. Results: No CDX2 expression was detected in the G1 or G3 groups; 5% of G2, 62.5% of G4 and 70.5% of G5 patients were CDX2 positive. There was a statistically significant difference between the G4 and G5 groups compared to the G1, G2 and G3 (p < 0.05). Conclusions: CDX2 expression was observed among patients with Barrett's esophagus and adenocarcinoma compared to other groups. CDX2 was not expressed in the phases preceding Barrett's esophagus, but there was no linear correlation between CDX2 expression and metaplasia-adenocarcinoma progression.

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Expression of CDX2 and MUC2 in Barrett's mucosa

Cited by 27 publications

References 27 publications

Foveolar type dysplasia in Barrett esophagus

Foveolar type dysplasia in Barrett esophagus

Hedgehog signaling regulates FOXA2 in esophageal embryogenesis and Barrett’s metaplasia

CDX2 Overexpression in Barrett’s Esophagus and Esophageal Adenocarcinoma

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