Prevalence of Barrett's esophagus and expression of mucin antigens detected by a panel of monoclonal antibodies in Barrett's esophagus and esophagealadenocarcinoma in Japan

Barrett's esophagus (BE) is an acquired disorder associated with a high inc idence of adenocarcinoma of the lower esophagus. Moreover, it has been repo rted that short-segment BE may be associated with adenocarcinoma of the eso phagogastric junction. The objective of this study was to define the preval ence of BE and the mucin profile in BE, including the short-segment type, a nd to compare the mucin profile in BE with the profiles of Barrett's adenoc arcinoma and distal esophageal adenocarcinoma among Japanese. In total, 650 adult subjects underwent endoscopic examination for evaluation of BE. Alth ough the prevalence of traditional (long segment) BE was 0.62%, the overall prevalence of BE including short-segment type was 15.7%. In Barrett's epit helium, the short-segment type predominantly had gastric type mucin, while the middle- and long-segment types possessed intestinal mucin, especially c olonic type mucin (sulfo-Lewis(a)), with high frequency. In Barrett's epith elium with adenocarcinoma, all Barrett's epithelium adjacent to carcinomas showed a predominance of immunoreactivity to sulfo-Lewis(a). In Barrett's a denocarcinomas, colonic type mucin was detected in 100% by monoclonal antib ody (MoAb) 91.9H. Small-intestinal mucin and gastric mucin were stained in 50% and 12.5% of the subjects, respectively. Colonic type mucin was also de tected with high frequency (80%) in distal esophageal adenocarcinomas witho ut Barrett's epithelium. These data suggest that the epitope, not of small- intestinal type or gastric type mucin, but of colonic type mucin (sulfo-Lew is(a)), may be associated with, at least in part, the malignant phenotype o f BE.