Z Gastroenterol 2013; 51 - A80
DOI: 10.1055/s-0033-1347530

Immunohistochemical analysis of protease activated receptor-2 (PAR2) and cyclooxygenase-2 (COX2) co expression in Barrett esophagus

Á Varga 1, L Tiszlavicz 1, I Németh 1, R Róka 2, F Izbéki 2, K Vadászi 2, T Wittmann 2, A Rosztóczy 2
  • 1Department of Pathology, University of Szeged, Szeged, Hungary
  • 21st Department of Medicine, University of Szeged, Szeged, Hungary

Our previous results suggested that the metaplastic process resulting in Barrett's esophagus is considered as a regenerative answer to mixed duodenogastric reflux. We also established that PAR2 is expressed on the metaplastic cells, and the expression showed correlation with the histological stage of the disease. Furthermore we demonstrated that COX2 similarly correlated with the reflux severity.

The aim of this study was to investigate the co expression of PAR2 and COX2 proteins in histological samples of patients with Barrett esophagus.

Materials and methods: Sixty-four consequtive human esophageal biopsy samples were studied. After the determination of the histological type of metaplasia, and the evaluation of dysplasia, immunoexpression results of PAR2 and COX2 were ranked on a semiquantitative scale, by two independent pathologists.

Results: From a total of 64 biopsy samples, in 49 cases (77%) intestinal metaplasia, in 5 cases (8%) fundic, while in 10 cases (16%) cardiac type metaplasia was confirmed. According to the grade of dysplasia, samples were divided into one of the four groups of modified Vienna classification: 35 patients (55%) – negative for dysplasia, 17 patients (27%) – low grade dysplasia, 11 patients (17%) – high grade dysplasia. In one case early stage adenocarinoma was described. Neither COX2 (p = 0,748), nor PAR2 (p = 0,131) expression showed a strong correlation with the type of metaplasia, notwithstanding that the expression of both COX2 (p = 0,004) and PAR2 (p = 0,001) significantly increased with the progression of dysplasia.

Conclusion: An increase in the immunoexpression of COX2 and PAR2 in routine biopsy samples can early predict the dysplastic progression of different intestinal metaplastic lesions, thus could be a potential additive histological marker for both routine pathological and clinical diagnostics. The study was organized by the South Hungarian Regional Surveillance Group for the Study of Barrett's Esophagus (B Bod, L Czakó, J Csanádi, K Csefkó, Z F.Kiss, P. Fricz, C Góg, J Hudák, K Intzédy, K Jármay, M Karácsony, Gy Lázár, Zs Lénárt, K Lovik, T Molnár, F Nagy, L Oczella, A Paszt, S Radics, L Szalay, A Szepes, Z Szepes, A Tiszai, A Titz, M Varga, A Váry, J Zombori).