Skip to main content
Log in

Distinct immunohistochemical findings in columnar epithelium of esophageal inlet patch and of Barrett's esophagus

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Immunohistochemistry was performed on biopsies of columnar mucosa from 11 patients with Barrett's esophagus and 11 patients with columnar mucosa in the cranial esophagus, the “inlet patch.” Both epithelia contained endocrine cells, immunoreactive to antisera against serotonin, glucagon, somatostatin, and pancreatic polypeptide; the specialized mucosa of Barrett's esophagus contained, in addition, neurotensin-immunoreactive cells, and in the mucosa of an inlet patch we found a gastrin cell. These findings are not compatible with some of the current theories on the origin of these epithelia. The mucosa of the inlet patch has been considered to consist of heterotopic gastric mucosa. The mucosa of the adult human stomach, however, does not contain glucagon cells. These cells are only present in the early embryonic stomach, and they disappear during embryonogenesis. According to our findings, the mucosa of the inlet patch therefore represents embryonic gastric mucosa. The specialized columnar epithelium of Barrett's esophagus has been considered to have evolved from gastric mucous neck cells. However, although glucagon cells are a feature of the embryonic stomach, neurotensin-immunoreactive cells have not been found in the gastric mucosa. Our study suggests that the specialized columnar epithelium of Barrett's esophagus originates from a very immature multipotent gastrointestinal stem cell.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Endo M, Kobayashi S, Kozu T, Takemoto T, Nakayama K: A case of Barrett epithelization followed up for five years. Endoscopy 6:48–51, 1974

    Google Scholar 

  2. Hassall E, Weinstein WM, Ament ME: Barrett's esophagus in childhood. Gastroenterology 89:1331–1337, 1985

    PubMed  Google Scholar 

  3. Spechler SJ, Goyal RK: Barrett's Esophagus Pathophysiology, Diagnosis and Management. New York, Elsevier, 1985

    Google Scholar 

  4. Paull A, Trier JS, Dalton MD, Camp RC, Loeb P, Goyal RK: The histologic spectrum of Barrett's esophagus. N Engl J Med 295:476–480, 1976

    PubMed  Google Scholar 

  5. Spechler SJ, Goyal RK: Barrett's esophagus. N Engl J Med 315:362–371, 1986

    PubMed  Google Scholar 

  6. Jabbari M, Goresky CA, Lough J, Yaffe C, Daly D, Côté C: The inlet patch: Heterotopic gastric mucosa in the upper esophagus. Gastroenterology 89:352–356, 1985

    PubMed  Google Scholar 

  7. Truong LD, Stroehlein JR, McKechnie JC: Gastric heterotopica of the proximal esophagus: A report of four cases detected by endoscopy and review of literature. Am J Gastroenterol 81:1162–1166, 1986

    PubMed  Google Scholar 

  8. Berenson MM, Herbst JJ, Freston JW: Enzyme and ultrastructural characteristics of esophageal columnar epithelium. Dig Dis Sci 19:895–907, 1974

    Google Scholar 

  9. Ozzello L, Savary M, Roethlisberger B: Columnar mucosa of the distal esophagus in patients with gastroesophageal reflux. Pathol Annu 12:41–86, 1977

    PubMed  Google Scholar 

  10. Rothery GA, Patterson JE, Stoddard CJ, Day DW: Histological and histochemical changes in the columnar lined (Barrett's) oesophagus. Gut 27:1062–1068, 1986

    PubMed  Google Scholar 

  11. Solcia E, Polak JM, Pearse AGE, et al: Lausanne 1977 classification of gastroenteropancreatic endocrine cells.In Gut Hormones. SR Bloom (ed). Edinburgh, Churchill Livingstone, 1978, pp 40–48

    Google Scholar 

  12. Eckardt VF, Nix W, Kraus W, Bohl J: Esophageal motor function in patients with muscular dystrophy. Gastroenterology 90:628–635, 1986

    PubMed  Google Scholar 

  13. Feurle GE, Helmstädter V, Forssmann WG: Immunohistochemical investigations in gastrin cells with specific antibodies against G-34, G-17 and partial gastrin sequences. Acta Hepato-Gastroenterol 25:508, 1978

    Google Scholar 

  14. Helmstädter V, Feurle GE, Forssmann WG: Insulin-, glucagon-, and somatostatin-immunoreactive endocrine cells in the equine pancreas. Cell Tissue Res 172:447–454, 1976

    PubMed  Google Scholar 

  15. Helmstädter V, Feurle GE, Forssmann WG: Relationship of glucagon-somatostatin and gastrin-somatostatin cells in the stomach of the monkey. Cell Tissue Res 177:29–46, 1977

    PubMed  Google Scholar 

  16. Helmstädter V, Taugner C, Feurle GE, Forssmann WG: Localization of neurotensin-immunoreactive cells in the small intestine of man and various mammals. Histochemistry 53:35–41, 1977

    PubMed  Google Scholar 

  17. Feurle GE, Büchler M, Helmstädter V: Gastric and enteral pancreatic polypeptide (PP) immunoreactivity in the dog. Acta Histochem 77:151–158, 1985

    PubMed  Google Scholar 

  18. Sternberger LA: Immunocytochemistry. Englewood Cliffs, Pennsylvania, Prentice-Hall, 1974, pp. 129–171

    Google Scholar 

  19. Trier JS: Morphology of the epithelium of the distal esophagus in patients with midesophageal peptic strictures. Gastroenterology 58:444–461, 1970

    PubMed  Google Scholar 

  20. Buchan AMJ, Grant S, Freeman HJ: Regulatory peptides in Barrett's oesophagus. J Pathol 146:227–234, 1985

    PubMed  Google Scholar 

  21. Dayal Y, Wolfe HJ: Endocrine cells in Barrett's epithelium.In Barrett's Esophagus. SJ Spechler, RK Goyal (eds). New York, Elsevier, 1985, pp 59–73

    Google Scholar 

  22. Griffin M, Sweeney EC: The relationship of endocrine cells, dysplasia and carcinoembryonic antigen in Barrett's mucosa to adenocarcinoma of the oesophagus. Histopathology 11:53–62, 1987

    PubMed  Google Scholar 

  23. Reid BJ, Rubin CE: When is the columnar-lined esophagus premalignant? Gastroenterology 88:1552, 1986

    Google Scholar 

  24. Shah KK, DeRidder PH, Shah KK: Ectopic gastric mucosa in proximal esophagus. J Clin Gastroenterol 8:509–513, 1986

    PubMed  Google Scholar 

  25. Larsson LI, Holst J, Hakanson R, Sundler F: Distribution and properties of glucagon immunoreactivity in the digestive tract of various mammals: An immunohistochemical and immunochemical study. Histochemistry 44:281–290, 1975

    PubMed  Google Scholar 

  26. Grimelius L, Capella C, Buffa R, Polak JM, Pearse AGE, Solcia E: Cytochemical and ultrastructural differentiation of enteroglucagon and pancreatic-type glucagon cells in the gastrointestinal tract. Virchows Arch B Cell Pathol 20:217–228, 1976

    PubMed  Google Scholar 

  27. Helmstädter V, Mühlmann G, Feurle GE, Forssmann WG: Ontogenesis of the endocrine cells of the human GEP system. Scand J Gastroenterol 13(Suppl 49):87, 1978

    PubMed  Google Scholar 

  28. Mühlmann G, Helmstädter V, Feurle GE, Forssmann WG: Untersuchungen zur Entwicklung der endokrinen Zellen des menschlichen GEP-Systems. Verh Anat Ges 72:599–601, 1978

    PubMed  Google Scholar 

  29. Grand RJ, Watkins JB, Torti FM: Development of the human gastrointestinal tract. Gastroenterology 70:790–810, 1976

    PubMed  Google Scholar 

  30. Johns BAE: Developmental changes in the oesophageal epithelium in man. J Anat 86:431–442, 1952

    PubMed  Google Scholar 

  31. Heading RC: Barrett's oesophagus. Br Med J 294:461–462, 1987

    Google Scholar 

  32. Herlihy KJ, Orlando RC, Bryson JC, Bozymski EM, Carney CN, Powell DW: Barrett's esophagus: Clinical, endoscopic, histologic, manometric and electrical potential difference characteristics. Gastroenterology 86:436–443, 1984

    PubMed  Google Scholar 

  33. Westerveld BD, Pals G, Bosma A, et al: Gastric proteases in Barrett's esophagus. Gastroenterology 93:774–778, 1987

    PubMed  Google Scholar 

  34. Levine DS, Rubin CE: Electron microscopic evidence for the gastric origin of Barrett's metaplasia and dysplasia. Gastroenterology 90:1519, 1986

    Google Scholar 

  35. Helmstädter V, Mühlmann G, Feurle GE, Forssmann WG: Immunohistochemical identification of gastrointestinal neurotensin cells in the human embryos. Cell Tissue Res 184:315–320, 1977

    PubMed  Google Scholar 

  36. Rindi G, Bishop AE, Daly MJ, Isaacs P, Lee FI, Polak JM: A mixed pattern of endocrine cells in metaplastic Barrett's oesophagus. Histochemistry 87:377–383, 1987

    PubMed  Google Scholar 

  37. Collier NA, Weinbren K, Bloom SR, Lee YC, Hodgson HJF, Blumgart LH: Neurotensin secretion by fibrolamellar carcinoma of the liver. Lancet 1:538–540, 1984

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This investigation was supported by a grant of the Deutsche Forschungsgemeinschaft Fe 127/5-7.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feurle, G.E., Helmstaedter, V., Buehring, A. et al. Distinct immunohistochemical findings in columnar epithelium of esophageal inlet patch and of Barrett's esophagus. Digest Dis Sci 35, 86–92 (1990). https://doi.org/10.1007/BF01537228

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01537228

Key words

Navigation