Acid Reflux Research - Diet, GERD (Gastro-Esophageal Reflux Disease), Treatment, Symptoms

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Cytokeratin 7 and 20 expression in intestinal metaplasia of the distal oesophagus: relationship to gastro-oesophageal reflux disease.

Shearer C, Going J, Neilson L, Mackay C, Stuart RC

Lister Department of Surgery and Department of Pathology, Glasgow Royal Infirmary, Glasgow, UK.

AIMS: Intestinal metaplasia and gastro-oesophageal reflux disease typify classical Barrett's oesophagus. Cytokeratin (CK) 7 and 20 phenotypes differentiate intestinal metaplasia in long segment Barrett's oesophagus from gastric intestinal metaplasia. This study examines the relationship between CK7/20 phenotypes and reflux disease in intestinal metaplasia of the distal oesophagus. METHODS AND RESULTS: Eighty patients with oesophageal pH studies included 30 with long segment Barrett's, 16 with short segment Barrett's and 34 with intestinal meatplasia of the gastro-oesophageal junction. Representative biopsy specimens were immunostained for CK7 and CK20. All 30 long segment patients demonstrated a Barrett's CK7/20 phenotype. All nine short segment patients with gastro-oesophageal reflux had a Barrett's CK7/20 phenotype, while four of seven short segment patients without reflux had a gastric CK7/20 phenotype (P = 0.019). Of 14 patients with intestinal metaplasia of the gastro-oesophageal junction and reflux, 10 (71%) had a Barrett's CK7/20 phenotype, compared with 11 (55%) of the 20 non-reflux patients. CONCLUSIONS: CK7/20 immunoreactivity for patients with intestinal metaplasia of the distal oesophagus without long segment Barrett's oesophagus suggests a heterogeneous group, with an association between Barrett's CK7/20 pattern and gastro-oesophageal reflux disease in both short segment Barrett's and intestinal metaplasia of the gastro-oesophageal junction.

Published 23 August 2005 in Histopathology, 47(3): 268-75.
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Acid Reflux Books

The Clinician's Guide to Acid/Peptic Disorders and Motility Disorders of the Gastrointestinal Tract (The Clinician's Guide to GI Series)

The Clinician's Guide to Acid/Peptic Disorders and Motility Disorders of the Gastrointestinal Tract (The Clinician's Guide to GI Series)