RESUMO
PURPOSE: Barrett's esophagus is one of the main risk factors for increased incidence of esophageal adenocarcinoma. In this study, we studied protein expression levels and cellular localizations of MUC-1, MUC-2, MUC-5AC, CK7, and cytoplasmic p27 to assess the relationship between the expression of each of these proteins and the disease progression on endoscopic biopsies. MATERIALS AND METHODS: Immunohistochemical analyses were performed using antibodies produced against MUC-1, MUC-2, MUC-5AC, CK7, and p27. Endoscopic specimens of esophageal mucosa were obtained from 72 patients who underwent esophagectomy for Barrett's esophagus, metaplasia, dysplasia, or esophageal adenocarcinoma developed from Barrett's esophagus. RESULTS: Multilayer squamous epithelium showed only MUC-1 positivity in the EAC group while MUC-2 and MUC-5AC staining could not be detected in this group. Strong and diffused membranous or cytoplasmic staining of CK7 was observed at squamous, ductal, surface columnar and/or glandular epithelium. c-p27 staining was diffused and moderate in the cellular membranes observed in all groups except for esophageal epithelial metaplasia without intestinal metaplasia. Additionally, weakly focal cytoplasmic staining in squamous epithelium of p27 in EAC was detected. CONCLUSIONS: Barrett's esophagus, which has a heterogeneous epithelium, might yield different diagnosis based on endoscopic evaluation and immunohistological investigation. Thus, the use of MUC1, p27, and CK7 might strengthen the truthful diagnosis. MUC-1, CK7, and c-p27 immunostaining can be used as the predictive markers for esophageal cancer progression from Barrett's esophagus.
