Korean J Gastroenterol.
2002 Nov;40(5):294-300.
Diagnostic Usefulness of Cytokeratin Immunoreactivity for Barrett's Esophagus
- Affiliations
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- 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. leesw@kumc.or.kr
- 2Department of Pathology, Korea University College of Medicine, Seoul, Korea.
- 3Department of Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND/AIMS: Cytokeratin (CK) 7/20 staining was reported to be helpful in diagnosing Barrett's esophagus (BE) and gastric intestinal metaplasia (IM). However, it is still in debate. We carried out this study to determine the diagnostic usefulness of CK 7/20 immunostaining for BE in Korea.
METHODS
In patients with endoscopic BE, two biopsy specimens were taken from just below the squamocolumnar junction (SCJ). For the case that goblet cell was positive in alcian blue staining, CK 7/20 immunohistochemical stain was performed. Esophagogastric junction (EGJ) IM was defined as the case that SCJ was located at less than 0.5 cm above EGJ and biopsy showed goblet cells. Barrett's CK 7/20 pattern was defined as the case that CK 20 is positive only in the superficial gland and CK 7 is positive both in the superficial and deep glands.
RESULTS
Barrett's CK 7/20 pattern was present in 4 (57.1%) of 7 cases with long-segment BE, 28 (77.8%) of 36 cases with short-segment BE, 11 (39.3%) of 28 cases with EGJ IM, and 9 (14.8%) of 61 cases with gastric IM. The sensitivity and specificity of Barrett's CK 7/20 pattern were 74.4% and 77.5%, respectively.
CONCLUSIONS
Barrett's CK 7/20 pattern can be a useful marker for the diagnosis of BE. However, the false positive and false negative rates are about 25%.
