Histology of Barrett's Metaplasia: Do Goblet Cells Matter?

This review has provided a summary of the biology of goblet cell metaplasia in CLE as it pertains to BE. Goblet cells are terminally differentiated nonproliferative cells that have many overlapping histochemical characteristics with mucinous columnar cells and pseudogoblet cells. There is an abundan...

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Publicado en:Digestive Diseases & Sciences Vol. 63; no. 8; pp. 2042 - 2052
Autor principal: Odze, Robert
Formato: research Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Springer Nature
      place: New York, New York
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        atl: Histology of Barrett's Metaplasia: Do Goblet Cells Matter?
      aug:
        au: Odze, Robert
        affil: Pathology Department, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, MR-07-714C, 02115-6105, Boston, MA, USA
      sug:
        subj:
          Epithelial Cells Pathology
          Esophagus Pathology
          Barrett Esophagus Pathology
          Intestine, Small Physiology
          Esophagus Physiology
          Intestine, Small Pathology
          Epithelial Cells Physiology
          Metaplasia Pathology
          Cell Differentiation Physiology
          Human
          Clinical Assessment Tools
          Short Portable Mental Status Questionnaire
      ab: This review has provided a summary of the biology of goblet cell metaplasia in CLE as it pertains to BE. Goblet cells are terminally differentiated nonproliferative cells that have many overlapping histochemical characteristics with mucinous columnar cells and pseudogoblet cells. There is an abundance of evidence that suggests that use of goblet cells as a biomarker of BE, and its progression to malignancy, is problematic. Some of these limitations include the fact that the background non-goblet epithelium in most patients with CLE is biologically intestinalized and contains molecular abnormalities similar to goblet cell CLE, goblet cells fluctuate with time and decrease in number with progression of neoplasia, and pathologists have problems with interpretation, and distinction, of goblet cells from other types of cells in the esophagus. Sampling error results in sensitivity and specificity issues that limit its positive predictive value. Goblet cells are fewest in number in the same population of patients with CLE that are hardest to detect endoscopically (i.e., those with short or ultrashort CLE). Nevertheless, the risk of cancer in patients with short-segment BE, a condition difficult to distinguish from the stomach, is very low regardless of the presence or absence of goblet cells so it is unclear what the role of goblet cells is in these patients as a biomarker. Nevertheless, if the answer to the following question, "Would you as a gastroenterologist recommend surveillance for a patient with clear endoscopic evidence of CLE, particularly if it is ≥ 3 cm in length, but in which goblet cells were not reported to be present by the pathologist," is yes, then the US requirement for goblet cells as part of the criteria for "BE" is superfluous.
      pubtype: Academic Journal
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        Journal Article
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    language: English
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