Expression of cyclin E in dysplasia, carcinoma, and nonmalignant lesions of Barrett esophagus.

Abstract

Barrett esophagus (BE) is a condition in which the normal squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium. BE is a premalignant lesion because it is the initiating factor in a metaplasia-dysplasia-carcinoma sequence. Expression of the proliferation-associated molecule cyclin E was immunohistochemically determined in metaplastic specialized epithelium (SE; n = 24), low grade dysplasia (LGD; n = 21), high grade dysplasia (HGD; n = 17), and invasive adenocarcinoma (CA; n = 35) from 36 esophagectomy specimens. In addition, endoscopically obtained samples of SE with minimal inflammatory changes (n = 11) and SE adjacent to erosions or ulcerations were tested for cyclin E expression. In the surgical specimens, expression of cyclin E was found in 0 of 24 SE (0%), 2 of 21 LGD (9.5%), 3 of 17 HGD (17.6%), and 5 of 35 CA (14. 3%). In the biopsy specimens, expression of cyclin E was found in all samples adjacent to erosions or ulcerations, whereas SE with minimal inflammatory changes was invariably negative for cyclin E. Accumulation of cyclin E can be found by means of immunohistochemistry in premalignant and malignant lesions in BE as well as in regenerative metaplastic epithelium. The determination of cyclin E expression is therefore not useful in the identification of BE patients with an increased risk for the development of carcinoma.