Intestinal metaplasia (IM) is a precursor for malignancies at the esophagogastric junction.
A monoclonal antibody, mAbDAS-1, may identify cellular characteristics of IM before the appearance of goblet cells.
In this study, researchers from the Netherlands and United States examined the prevalence of mAbDAS-1 positivity in biopsies from the squamocolumnar junction (SCJ).
They aimed to correlate this positivity with the presence of IM and clinical findings.
The team assessed 559 patients whose reflux symptoms were scored.
The presence of reflux esophagitis and hiatus hernia was evaluated during endoscopy.
| mAbDAS-1 positivity occurred in 41% of patients without intestinal metaplasia.|
|American Journal of Gastroenterology|
The researchers obtained 2 biopsy specimens from the SCJ.
In a subset of patients (n = 99), biopsies from the endoscopically defined cardiac region (2 cm distal to proximal margin of gastric folds) were available.
The team stained biopsy specimens with hematoxylin and eosin, Alcian Blue, modified Giemsa, and mAbDAS-1.
The research team observed mAbDAS-1 positivity in the SCJ biopsies of 41% of patients without IM, and in 88% of patients with IM.
Patients without IM but with antibody positivity showed similar histological characteristics as patients with IM at the SCJ.
In addition, biopsies of 123 of 559 patients revealed a columnar-cuboidal epithelium, which was found to be mAbDAS-1 positive in 64%.
Tissue specimens from the cardiac region without IM, stained positive in 14% (13 of 91), 12 of those also stained at the SCJ.
Dr Claudia Rogge-Wolf’s team concluded, “In patients without IM, a high prevalence of mAbDAS-1 positivity was observed”.
“Biopsies of these patients showed similar histological characteristics as patients with IM.”
“Although not all patients exhibiting this reactivity may develop IM, mAbDAS-1 reactivity may help in the understanding of the histogenesis of IM at the SCJ.”