AIM:To compare the sensitivity and specificity of CDX2 and alcian blue(AB) p H 2.5 staining in identifying esophageal intestinal metaplasia.METHODS:One hundred and ninty-nine biopsies from 186 patients were retrospect...AIM:To compare the sensitivity and specificity of CDX2 and alcian blue(AB) p H 2.5 staining in identifying esophageal intestinal metaplasia.METHODS:One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett's esophagus(BE)(n =108); non-Barrett's esophagus(NBE)(n =48); columnar blue cells(CB) and esophageal glands(EG)(n =43).The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex(clone CDX2-88) and the Ventana Discovery X automated immunostainer.The positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal metaplasia.RESULTS:All of the 108 BE biopsies(100%) were positive for AB and 102 of them(94.4%) were positive for CDX2.The six BE patients(5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for immunostaining.Both AB and CDX2 were negative in 43 out of 48(89.6%) NBE cases.Five NBE patients(10.4%) were falsely positive for AB due to the presence of EG and CB in these biopsies.These cases were all CDX2 negative.In addition,5 AB negative NBE were found to be CDX2 positive.Based on these results the CDX2 immunostain had similar sensitivity but higher specificity(100% vs about 91%) than AB in detecting intestinal type metaplasia in these samples.Our data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB(95.6% vs 71.5%,respectively).CONCLUSION:CDX2 has a better positive predictive value than AB in detecting intestinal metaplasia.CDX2may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.展开更多
AIM: To investigate the effect of a fat rich diet onnon-steroidal anti-inflammatory drug(NSAID)-induced mucosal damage in the murine small intestine.METHODS: C57BL6 mice were fed 4 types of diets with or without indom...AIM: To investigate the effect of a fat rich diet onnon-steroidal anti-inflammatory drug(NSAID)-induced mucosal damage in the murine small intestine.METHODS: C57BL6 mice were fed 4 types of diets with or without indomethacin.One group was fed standard laboratory chow.The other groups were fed a fat diet consisting of 8% w/w fat,beef tallow(rich in SFA),fish oil,(rich in omega-3 PUFA),or safflower oil(rich in omega-6 PUFA).Indomethacin(3 mg/kg) was injected intraperitoneally from day 8 to day 10.On day 11,intestines and adhesions to submucosal microvessels were examined.RESULTS: In the indomethacin-treated groups,mucosal damage was exacerbated by diets containing beef tallow and fish oil,and was accompanied by leukocyte infiltration(P < 0.05).The mucosal damage induced by indomethacin was significantly lower in mice fed the safflower oil diet than in mice fed the beef tallow or fish oil diet(P < 0.05).Indomethacin increased monocyte and platelet migration to the intestinal mucosa,whereas safflower oil significantly decreased monocyte and platelet recruitment(P < 0.05).CONCLUSION: A diet rich in SFA and omega-3 PUFA exacerbated NSAID-induced small intestinal damage via increased leukocyte infiltration.Importantly,a diet rich in omega-6-PUFA did not aggravate inflammation as monocyte migration was blocked.展开更多
文摘AIM:To compare the sensitivity and specificity of CDX2 and alcian blue(AB) p H 2.5 staining in identifying esophageal intestinal metaplasia.METHODS:One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett's esophagus(BE)(n =108); non-Barrett's esophagus(NBE)(n =48); columnar blue cells(CB) and esophageal glands(EG)(n =43).The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex(clone CDX2-88) and the Ventana Discovery X automated immunostainer.The positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal metaplasia.RESULTS:All of the 108 BE biopsies(100%) were positive for AB and 102 of them(94.4%) were positive for CDX2.The six BE patients(5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for immunostaining.Both AB and CDX2 were negative in 43 out of 48(89.6%) NBE cases.Five NBE patients(10.4%) were falsely positive for AB due to the presence of EG and CB in these biopsies.These cases were all CDX2 negative.In addition,5 AB negative NBE were found to be CDX2 positive.Based on these results the CDX2 immunostain had similar sensitivity but higher specificity(100% vs about 91%) than AB in detecting intestinal type metaplasia in these samples.Our data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB(95.6% vs 71.5%,respectively).CONCLUSION:CDX2 has a better positive predictive value than AB in detecting intestinal metaplasia.CDX2may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.
基金Supported by National Defense Medical College,by Intractable Diseasesthe Health and Labour Sciences Research Grants fromMinistry of HealthLabour and Welfare and by Research for the similarity and difference in epidemiology,pathophysiology,diagnosis and treatment of rare intestinal refractory diseases andby a grant from the Smoking Research Foundation
文摘AIM: To investigate the effect of a fat rich diet onnon-steroidal anti-inflammatory drug(NSAID)-induced mucosal damage in the murine small intestine.METHODS: C57BL6 mice were fed 4 types of diets with or without indomethacin.One group was fed standard laboratory chow.The other groups were fed a fat diet consisting of 8% w/w fat,beef tallow(rich in SFA),fish oil,(rich in omega-3 PUFA),or safflower oil(rich in omega-6 PUFA).Indomethacin(3 mg/kg) was injected intraperitoneally from day 8 to day 10.On day 11,intestines and adhesions to submucosal microvessels were examined.RESULTS: In the indomethacin-treated groups,mucosal damage was exacerbated by diets containing beef tallow and fish oil,and was accompanied by leukocyte infiltration(P < 0.05).The mucosal damage induced by indomethacin was significantly lower in mice fed the safflower oil diet than in mice fed the beef tallow or fish oil diet(P < 0.05).Indomethacin increased monocyte and platelet migration to the intestinal mucosa,whereas safflower oil significantly decreased monocyte and platelet recruitment(P < 0.05).CONCLUSION: A diet rich in SFA and omega-3 PUFA exacerbated NSAID-induced small intestinal damage via increased leukocyte infiltration.Importantly,a diet rich in omega-6-PUFA did not aggravate inflammation as monocyte migration was blocked.
