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Letter
Cytokeratin immunoreactivity of intestinal metaplasia
  1. I A Mouzas1,
  2. I Jovanovic2,
  3. T Milosavljevic2,
  4. M Tzardi3,
  5. P Kanavaros4
  1. 1Department of Gastroenterology, Medical School, University of Crete, Greece
  2. 2Institute of Digestive Disease-University Clinical Center of Serbia, Belgrade, Yugoslavia
  3. 3Department of Pathology, Medical School, University of Crete, Greece
  4. 4Department of Anatomy-Histology, Medical School, University of Ioannina, Greece
  1. Correspondence to:
    I A Mouzas, Crete University, Heraklion, Medical School, PO Box 1393, 71110 Heraklion, Greece;
    mouzas{at}med.uoc.gr

https://doi.org/10.1136/gut.51.6.894-a

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    We read with great interest the well designed study of Couvelard et al (Gut 2001;49:761–6). In agreement with other studies,1–3 the authors reported that cytokeratin (CK) 7 and 20 immunoreactivity in the specialised intestinal metaplasia found in Barrett’s oesophagus differs from the intestinal metaplasia found in the stomach. The specific pattern of CK7/CK20 expression, so-called Barrett’s type, is characterised by strong CK7 staining of both superficial and deep glands together with a strong superficial CK20 stain. The authors report that both clinical and endoscopic findings support this differentiation.

    The origin and development of intestinal metaplasia at the gastro-oesophageal junction have been a matter for debate. There are findings suggesting that intestinal metaplasia of the cardia has an immunophenotype similar to Barrett’s oesophagus3 while others suggest that it is similar to the rest of the gastric mucosa.1 We evaluated the CK7/CK20 pattern of gastric cardia with intestinal metaplasia and compared it with Barrett’s oesophagus, corpus, and antrum metaplasia in 68 endoscopic biopsies and selected surgical specimens.4 Immunostaining was performed using the same monoclonal antibodies for CK7 and CK20 as in the study of Couvelard et al for all specimens of Barrett’s (n=17), cardia metaplasia (n=15), corpus metaplasia (n=14), and antrum metaplasia (n=22).

    We found three patterns of CK7/CK20 immunostaining and identified them as IM-1, IM-2, and IM-3. IM-1 is characterised by strong diffuse CK7 staining in both superficial and deep …

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