Cytokeratin immunoreactivity patterns in the diagnosis of short-segment Barrett's esophagus

Gastroenterology. 2000 Sep;119(3):683-90. doi: 10.1053/gast.2000.16482.


Background & aims: The origin of intestinal metaplasia in short segments of columnar mucosa at the esophagogastric junction has clinical importance but can be difficult to determine at endoscopy. Cytokeratin (CK) 7 and 20 patterns are specific for long-segment Barrett's esophagus; however, their utility in short-segment Barrett's esophagus has not been assessed.

Methods: Endoscopic biopsy specimens from patients with long-segment Barrett's esophagus (n = 49), suspected short-segment Barrett's esophagus (n = 43), and gastric intestinal metaplasia (n = 26) were immunostained for CK7 and CK20. Comprehensive clinical data were obtained, including age, gender, and hiatal hernia and Helicobacter pylori status.

Results: A Barrett's CK7/20 pattern was present in 48 (98%) of 49 patients with long-segment Barrett's esophagus, 35 (82%) of 43 with suspected short-segment Barrett's esophagus, and 0 (0%) of 26 patients with gastric intestinal metaplasia. Patients with suspected short-segment Barrett's esophagus with a Barrett's CK7/20 pattern were clinically similar to those with long-segment Barrett's esophagus. In contrast, patients with suspected short-segment Barrett's esophagus with no Barrett's CK7/20 pattern were clinically similar to those with gastric intestinal metaplasia.

Conclusions: A Barrett's CK7/20 pattern identifies a subset of patients with suspected short-segment Barrett's esophagus who have a patient profile similar to that seen in long-segment Barrett's esophagus. A Barrett's CK7/20 pattern is an objective marker of Barrett's mucosa that in conjunction with appropriate clinical and endoscopic data can be used by clinicians to better define patients with short-segment Barrett's esophagus.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Barrett Esophagus / diagnosis*
  • Barrett Esophagus / metabolism*
  • Barrett Esophagus / pathology
  • Cohort Studies
  • Esophagoscopy
  • Esophagus / metabolism
  • Esophagus / pathology
  • Female
  • Gastric Mucosa / metabolism
  • Humans
  • Immunologic Techniques
  • Intermediate Filament Proteins / metabolism*
  • Intestinal Mucosa / metabolism
  • Intestines / pathology
  • Keratin-20
  • Keratin-7
  • Keratins / metabolism*
  • Male
  • Metaplasia / metabolism
  • Middle Aged
  • Mucous Membrane / metabolism
  • Mucous Membrane / pathology
  • Observer Variation
  • Stomach / pathology


  • Intermediate Filament Proteins
  • KRT20 protein, human
  • KRT7 protein, human
  • Keratin-20
  • Keratin-7
  • Keratins