Original Paper

Digestive Diseases and Sciences

, Volume 53, Issue 6, pp 1488-1492

First online:

Alterations in the Density of Interstitial Cells of Cajal in Achalasia

  • Arman KilicAffiliated withHeart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center
  • , James D. LuketichAffiliated withHeart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center
  • , Rodney J. LandreneauAffiliated withHeart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center
  • , Scott R. OwensAffiliated withDepartment of Pathology, University of Pittsburgh Medical Center
  • , Alyssa M. KrasinskasAffiliated withDepartment of Pathology, University of Pittsburgh Medical Center
  • , Matthew J. SchuchertAffiliated withHeart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical CenterHeart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center Email author 

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Abstract

The aim of this study was to assess the quantity of interstitial cells of Cajal (ICC) in the lower esophageal sphincter (LES) in achalasia. LES muscle was obtained from 11 achalasia and nine esophageal cancer (control) patients during surgery. Immunohistochemistry was performed and average cell counts per high-power field (HPF) were obtained. Overall, more ICC were observed in achalasia (median = 14.0 cells/HPF; range = 0–22.6 cells/HPF) as compared with controls (median = 6.2 cells/HPF; range = 1.6–10.8 cells/HPF) (P = 0.047). There were two subsets of findings within the achalasia group: 8/11(73%) had an increased quantity of ICC (median = 17.1 cells/HPF; range = 11.6–22.6; P = 0.015) as compared with controls, whereas the remaining 3/11(27%) had a paucity of ICC (median = 0 cells/HPF; range = 0–2; P = 0.02). ICC levels were positively correlated with age of the patient (P = 0.043). Our study demonstrates that subsets of abnormal ICC levels are observed in idiopathic achalasia of the esophagus.

Keywords

Achalasia Motility Esophageal Interstitial cells Cajal ICC Megaesophagus