Year: 2011
Type: article
Study design: Observational Study
Abstract: We evaluated hepatocyte paraffin 1 (HepPar1) antigen expression, a sensitive marker of small intestinal differentiation, in combination with morphologic features to demonstrate intestinal differentiation in cases equivocal for Barrett esophagus (BE).Clinicopathologic features and HepPar1 expression were recorded for 54 BE cases, 45 consistent with reflux esophagitis (RE) cases, and 65 "suspicious" for BE (SBE) cases.The SBE category included RE cases with 2 or more morphologic changes associated with BE or metaplastic reaction to injury (eg, multilayered epithelium, squamous islands, goblet cell mimickers, pancreatic metaplasia).HepPar1 was expressed in all 54 BE cases, 4 of 45 RE cases, and 24 of 65 SBE cases.In SBE cases, 2 or more morphologic changes were associated with HepPar1 expression in 37% of cases (24/65), 3 or more features in 59% (13/22), and 4 or more features in 100% (4/4) (P ≤ .004).The combination of certain morphologic changes and HepPar1 expression in clinically suspicious distal esophageal biopsy cases without goblet cells supports the presence of evolving intestinal metaplasia.Upon completion of this activity you will be able to: • define the American College of Gastroenterology (ACG) requirements for a diagnosis of Barrett esophagus and compare and contrast these with the British Society of Gastroenterology (BSG) requirements.• define the antigen target of hepatocyte paraffin 1 (HepPar1) antibody and describe the pattern of immunohistochemical staining.• discuss the different morphologic features that can be identified in distal esophageal biopsies and how these correlate with clinical impression and potential markers of intestinal differentiation.The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit ™ per article.Physicians should claim only the credit commensurate with the extent of their participation in the activity.This activity qualifies as an American Board of Pathology Maintenance of Certification Part II Self-Assessment Module.The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Award: Mouse Immunopathology
OpenAlex ID: W2144338349