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Usefulness of endoscopic brushing and magnified endoscopy with narrow band imaging (ME-NBI) to detect intestinal phenotype in columnar-lined esophagus

  • Original Article—Alimentary Tract
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Abstract

Background

Barrett’s esophagus with specialized intestinal metaplasia (SIM), which is at high risk of progressing to esophageal adenocarcinoma, has been identified by obtaining biopsy specimens randomly. Magnified endoscopy with narrow band imaging (ME-NBI) is reported to be useful for detecting SIM or the intestinal phenotype. We aimed to evaluate the usefulness of endoscopic brushing followed by ME-NBI for the detection of the intestinal phenotype.

Methods

Biopsy and brushing samples were taken following endoscopic observation by ME-NBI. Total RNA was extracted from the whole sample and microdissected samples, and quantitative reverse transcription-polymerase chain reaction (PCR) analysis of SHH, CDX2, and mucin mRNA expression was performed.

Results

Fifty patients (32 men, 18 women, average age 67.3 years) with metaplastic columnar epithelium of the lower esophagus were studied. MUC2 (85 vs. 65 %) and CDX2 (95 vs. 75 %) were detected more frequently in the brushing samples than in the biopsy samples. MUC2 expression levels were significantly higher in the brushing samples than those in the biopsy samples. CDX2 and MUC2 expression levels in the brushing samples were significantly higher in the mucosa with tubular/villous pattern observed by ME-NBI than the levels in mucosae with other patterns.

Conclusions

Endoscopic brushing in mucosa of columnar epithelium with a tubular/villous pattern visualized by ME-NBI is useful to detect the intestinal phenotype.

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Conflict of interest

All authors have no conflict of interest and there were no funding sources for the study, including pharmaceutical and industry support.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Takahisa Murao, Akiko Shiotani, Yoshiyuki Yamanaka, Yoshiki Kimura, Hideaki Tsutsui, Hiroshi Matsumoto, Tomoari Kamada & Ken Haruma

  2. Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan

    Noriaki Manabe & Jiro Hata

Authors
  1. Takahisa Murao
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  2. Akiko Shiotani
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  3. Yoshiyuki Yamanaka
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  4. Yoshiki Kimura
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  6. Hiroshi Matsumoto
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  7. Tomoari Kamada
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  10. Ken Haruma
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Correspondence to Takahisa Murao.

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Murao, T., Shiotani, A., Yamanaka, Y. et al. Usefulness of endoscopic brushing and magnified endoscopy with narrow band imaging (ME-NBI) to detect intestinal phenotype in columnar-lined esophagus. J Gastroenterol 47, 1108–1114 (2012). https://doi.org/10.1007/s00535-012-0589-9

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  • DOI: https://doi.org/10.1007/s00535-012-0589-9

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