Significance of paneth cell metaplasia in Barrett esophagus: a morphologic and clinicopathologic study

The metaplastic intestinal epithelium in Barrett esophagus (BE) occasionally contains Paneth cells; however, little is known regarding the prevalence and significance of Paneth cell metaplasia (PCM) in BE. We evaluated 757 esophageal biopsy specimens with intestinal metaplasia (IM) for PCM. Outcome...

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Bibliographic Details
Published in:American journal of clinical pathology 2015-05, Vol.143 (5), p.665-671
Main Authors: Chen, Wei, Frankel, Wendy L, Cronley, Kevin M, Yu, Lianbo, Zhou, Xiaoping, Yearsley, Martha M
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adult
Aged
Aged, 80 and over
Barrett Esophagus - epidemiology
Barrett Esophagus - pathology
Biopsy
Esophagus - pathology
Female
Follow-Up Studies
Humans
Intestinal Mucosa - pathology
Male
Metaplasia - epidemiology
Metaplasia - pathology
Middle Aged
Paneth Cells - pathology
Precancerous Conditions - epidemiology
Precancerous Conditions - pathology
Prevalence
Regression Analysis
Young Adult
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Summary:The metaplastic intestinal epithelium in Barrett esophagus (BE) occasionally contains Paneth cells; however, little is known regarding the prevalence and significance of Paneth cell metaplasia (PCM) in BE. We evaluated 757 esophageal biopsy specimens with intestinal metaplasia (IM) for PCM. Outcome analysis was performed in 299 cases with complete clinical data using multinomial logistic regression. Thirty-one percent (234/757) of the IM cases showed PCM. Paneth cells are decreased when BE epithelium becomes increasingly dysplastic. Long-segment BE shows significantly more PCM than short-segment BE. On follow-up biopsies, patients without PCM (NPCM) are three times more likely to regress than patients with PCM, regardless of dysplasia, BE segment length, age, or sex. However, there is no significant difference in terms of progression to dysplasia/adenocarcinoma between the PCM and NPCM groups. The presence of PCM is associated with less disease regression and is not associated with more disease progression.
ISSN:0002-9173
1943-7722
DOI:10.1309/AJCPVUJMCVBC9PKM