BARRETTS-ESOPHAGUS - MUCIN COMPOSITION, NEUROENDOCRINE CELLS, P53 PROTEIN, CELLULAR PROLIFERATION AND DIFFERENTIATION

There is strong association of Barrett's oesophagus (BO) with adenocar cinoma. The sequence of events preceding malignancy appears to be refl ux oesophagitis - ulceration - BO - dysplasia. One hundred and five bi opsies of heterotopic columnar epithelium were stained for H&E, PAS/Al cian Blue and HID/Alcian Blue for the routine histology and neutral/ac idic sialo- and sulphomucin staining. Other sections were silver impre gnated by the Grimelius technique, Immunohistochemical techniques were applied for the assessment of the accumulation of p53 protein, ''S'' phase of the replication cell cycle using proliferating cell nuclear a ntigen (PCNA), marked for cell differentiation and proliferation using EGF and TGFa. 105 cases of heterotopic columnar epithelium consisted of 74 cases of BO, 25 junctional and 7 corpus mucosa. Dysplastic BO (n =9) showed similar amount of sulphomucin and endocrine cell number whe n compared to non-dysplastic. PCNA study revealed a close similarity b etween dysplastic, indefinite for dysplasia and non-dysplastic, mucosa l positive counts. Growth factors activity was significantly higher in dysplastic and indefinite than in non-dysplastic, but no such differe nce was found between dysplastic and indefinite for dysplasia BO. Ther e was a significant concurrent p53 expression in dysplastic and indefi nite for dysplasia BO. In conclusion, the practical utility of mucin s tainings, endocrine cell count, assessment of cell proliferation and d ifferentiation by PCNA, EGF and TGFa seems to be limited in differenti ation of the dysplastic and indefinite for dysplasia BO. Altered expre ssion of p53, particularly in combination with EGF and TGFa, may be us eful in studying these lesions.