The expression of CDX-2 and p53 immunohistochemical markers — a useful diagnostic tool for glandular dysplasia in Barrett’s oesophagus
, 1, 2, 3, 4, 1
Streszczenie
Introduction. Barret’s esophagus (BE), is a common state, concerning roughly about 15% of GERD patients. The pathomechanism of BE is replacement of typical squamous-cell mucosa by a layer of intestinal-type glandular mucosa (intestinal metaplasia). In a number of cases the glands are prone to dysplasia which may lead to the occurrence of esophageal adenocarcinoma. The golden standard in diagnosis of BE is endoscopy combined with histopathological examination of biopsy material of the altered Z line. Unfortunately, many guidelines do not recommend endoscopic treatment in most cases of BE in favor of long-term screening, reserving the need for treatment for dysplastic BE.
Material and methods. 53 patients suspected of BE (study group) and 45 patients without any macroscopic signs of BE (control group) underwent upper GI endoscopy during which several biopsies were taken from the elevated Z line. The study group was divided into 2 subgroups: I — without histopathological evidence of BE (n = 11); II — histopathologically confirmed BE (n = 42). In addition to the standard histopathological examination, the material was screened for levels of CDX2 and p53 expression.
Results. In the control group, none of the patients presented elevated CDX2 or p53 expression (0%). In the study group, 24 patients were CDX2 positive (45.28%) and 27 were p53 positive (50.94%). Both markers were positive in 21 cases (39.62%).
Conclusions. Standard histopathological examination combined with immunohistochemical examination can prove to be a useful tool in confirming the diagnosis of BE, diagnosing early glandular displasia and, in some cases, eliminating false negative results.
Słowa kluczowe: Barrett’s oesophagusoesophageal adenocarcinomap53CDX-2
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