Abstract
In a retrospective histological study, resected specimens obtained from 23 patients with adenocarcinoma in Barrett's esophagus (Group I) and endoscopic multiple (step) biopsis from 38 patients without carcinoma in Barrett's esophagus (Group II) were investigated for dysplastic changes. Dysplasia was most frequently found in the type of mucosa comprising intestinal metaplasia. There seem to be two pathways to dysplasia in Barrett's esophagus. In Group I dysplasia was found in 18 out of 23, and in Group II in 2 out of 38 patients. In Barrett's esophagus, dysplasia may be considered not only a precursor of carcinoma, but also a marker for coexisting carcinoma.
Key words: Barrett's esophagus, Dysplasia, Carcinoma
References
- 1.Belladonna JA, Hajdu SI, Bains MS, Winawer SJ (1974) Adenocarcinoma in situ of Barrett's esophagus diagnosed by endoscopic cytology. N Engl J Med 291:895–896 [DOI] [PubMed] [Google Scholar]
- 2.Berenson MM, Riddell RH, Skinner DB, Freston JW (1978) Malignant transformation of esophageal columnar epithelium. Cancer 41:554–561 [DOI] [PubMed] [Google Scholar]
- 3.Blackstone MO, Riddell RH, Rogers BHG, Levin B (1981) Dysplasia-associated lesion or mass (DALM) detected by colonos-copy in long-standing ulcerative colitis: An indicator for colectomy. Gastroenterology 80:366–374 [PubMed] [Google Scholar]
- 4.Cuello C, Correa P, Zamara G, Lopez J, Murray J, Gordillo G (1979) Histopathology of gastric dysplasias. Am J Surg Pathol 3:491–500 [DOI] [PubMed] [Google Scholar]
- 5.Geboes K, Vanstapel MJ, Desmet VJ, Vantrappen G (1981) Tissue demonstration of carcinoembryonic antigen (CEA) in columnar esophageal epithelium. Hepatogastroenterology 28:324–326 [PubMed] [Google Scholar]
- 6.Grundmann E (1975) Histologic types and possible initial stages in early gastric carcinoma. Beitr Pathol 154:256–280 [DOI] [PubMed] [Google Scholar]
- 7.Haggitt RC, Tryzelaar J, Ellis FH, Colcher H (1978) Adenocarcinoma complicating columnar epithelium-lined (Barrett's) esophagus. Am J Clin Pathol 70:1–5 [DOI] [PubMed] [Google Scholar]
- 8.Hall C, Hoie J, Langmark F (1982) Adenocarcinoma in Barrett's esophagus. Scand J Thor Cardiovasc Surg 16:107–109 [DOI] [PubMed] [Google Scholar]
- 9.Herbst JJ, Berenson MM, McCloskey DW, Wiser WC (1978) Cell proliferation in esophageal columnar epithelium (Barrett's esophagus). Gastroenterology 75:683–687 [PubMed] [Google Scholar]
- 10.Herlihy KJ, Orlando RC, Brysen JC, Bozymski EM, Carney CN, Powell DW (1984) Barrett's esophagus: clinical, endoscopic, histologic, manometric, and electrical potential difference characteristics. Gastroenterology 86:463–443 [PubMed] [Google Scholar]
- 11.Jass JR (1981) Mucin histochemistry of the columnar epithelium of the oesophagus: A retrospective study. J Clin Pathol 34:866–870 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Kalish RJ, Clancy PE, Orringer MB, Appelman HD (1984) Clinical, epidemiologic, and morphologic comparison between adenocarcinomas arising in Barrett's esophageal mucosa and in the gastric cardia. Gastroenterology 86:461–467 [PubMed] [Google Scholar]
- 13.Levine MS, Caroline D, Thompson JJ, Kressel HJ, Läufer J, Herlinger H (1984) Adenocarcinoma of the esophagus. Relationship to Barrett mucosa. Radiology 150:305–309 [DOI] [PubMed] [Google Scholar]
- 14.McDonald GB, Brand DL, Thorning DR (1977). Multiple adenomatous neoplasms arising in columnar-lined (Barrett's) esophagus. Gastroenterology 72:1717–1321 [PubMed] [Google Scholar]
- 15.Menguy R (1979) On the malignant potential of acquired short esophagus. Arch Surg 114:260–263 [DOI] [PubMed] [Google Scholar]
- 16.Ming SC (1979) Dysplasia of the gastric epithelium. Front Gastrointest Res 4:164–172 [DOI] [PubMed] [Google Scholar]
- 17.Morson BC, Sobin LH, Grundmann E, Johansen A, Nagayo T, Serck-Haussen A (1980) Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol 33:711–721 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Naef AP, Savary M, Ozello L (1975) Columnar-lined lower esophagus: An acquired lesion with malignant predispositions. J Thorac Cardiovasc Surg 70:826–834 [PubMed] [Google Scholar]
- 19.Nagayo T (1981) Dysplasia of the gastric mucosa and its relationship to the precancerous state. Gann 72:813–823 [PubMed] [Google Scholar]
- 20.Oehlert W, Keller P, Henke M, Strauch M (1979) Gastric mucosal dysplasia: What is its significance? Front Gastrointest Res 4:173–182 [DOI] [PubMed] [Google Scholar]
- 21.Paull A, Trier JS, Dalton MD, Camp RC, Loeb P, Goyal RK (1976) The histological spectrum of Barrett's esophagus. N Engl J Med 295:476–480 [DOI] [PubMed] [Google Scholar]
- 22.Pellish LJ, Hermos JA, Eastwood GL (1980) Cell proliferation in three types of Barrett's epithelium Gut 21:26–31 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Riddell RH, Goldmann H, Ransohoff DF, Appelmann HD, Fenoglio CM, Haggitt RC, Ahren C, Correa P, Hamilton SR, Morson BC, Sommers SC, Jardley JH (1983) Dysplasia in inflammatory bowel disease: Standardized classification with provisional clinical applications. Hum Pathol 14:931–968 [DOI] [PubMed] [Google Scholar]
- 24.Sjogren RW, Johnson LF (1983) Barrett's esophagus: A review. Am J Med 74:313–321 [DOI] [PubMed] [Google Scholar]
- 25.Thompson JJ, Zinsser KR, Enterline HT (1983) Barrett's metaplasia and adenocarcinoma of the esophagus and gastro esophageal junction. Hum Pathol 14:42–61 [DOI] [PubMed] [Google Scholar]
- 26.Weinstein W, van Deventer G, Ippoliti A (1984) A histologic evaluation of Barrett's esophagus using a standardized endoscopic biopsy protocol. Gastroenterology 86:1296 [Google Scholar]