Comparación de la expresión de mucosustancias ácidas en pacientes con Esófago de Barret
Cargando...
Archivos
Fecha
2008
Profesor/a Guía
Facultad/escuela
Idioma
es
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
El esófago de Barrett (EB) ha sido y seguirá siendo tema de
investigación, ya que tiene una estrecha relación con el reflujo gastroesofágico. Si
bien la metaplasia intestinal no es considerada directamente como una lesión
precancerosa, si se considera un elemento histológico diagnóstico para EB y la
displasia epitelial un riesgo para desarrollar un adenocarcinoma esofágico. De ahí la
importancia de un diagnóstico certero que permita tomar una conducta clínica
adecuada.
En los distintos tipos de metaplasia intestinal se pueden utilizar como
marcador las células caliciformes, las células columnares y sus secreciones de
mucusustancias ácidas, mediante la tinción de Alcian blue a pH 2.5 y pH 1, que tiñe
las sialomucinas y sulfomucinas respectivamente. Esto nos permite clasificar las
metaplasias completa e incompleta según el tipo de mucina secretada, siendo la más
ácida (sulfomucina) la con mayor presencia en epitelios con MI (metaplasia
intestinal) de tipo incompleta.
En este trabajo se realizó un estudio en pacientes con diagnóstico
histológico de EB, y sobre estos se aplicó la técnica histoquímica de Alcian Blue a
pH 2.5 y pH 1. De una población de 206 pacientes con EB pertenecientes al
Hospital Naval “Almirante Neff” de Viña del Mar , entre los años 2000-2006
obteniendo una muestra de 25 pacientes con displasia de los cuales 18 (72%)
mostraron displasia epitelial de bajo grado (DBG) y 7 (28%) displasia epitelial de
alto grado (DAG) . Se aplicaron ambos pH (2.5 y 1) a cada una de las muestras para
luego ser analizadas bajo microscopio, en búsqueda de secreción de mucosustancias
acidas.
Al realizar ambas técnica se demostró presencia de sialomucinas y
sulfomucinas en el 96% de las placas, lo que indica que solo en un caso no se
obtuvo tinción y fue a pH 1. Se pudo determinar que la presencia de sialomucinas y
sulfomucinas en displasia epitelial disminuye notablemente en la zona displásica,
principalmente en la DAG.
Barrett's esophagus (BE) has been and will be the subject of investigation, it has a close relationship with gastroesophageal reflux. While intestinal metaplasia is not considered directly as a precancerous lesion, where a histological diagnosis for EB epithelial dysplasia and a risk of developing esophageal adenocarcinoma. Hence the importance of an accurate diagnosis for taking an appropriate clinical behavior. In the various types of intestinal metaplasia can be used as a marker of goblet cells, columnar cells and their secretion of acid mucusustancias by Alcian blue stain at pH 2.5 and pH 1, which stained the sialomucinas and sulfomucinas respectively. This allows us to classify the complete and incomplete metaplasia depending on the type of mucin secreted, the most acidic (sulfomucina) with the largest presence in epithelia with MI (intestinal metaplasia) type incomplete. This paper conducted a study in patients with histological diagnosis of EB, and these techniques were applied histochemistry Alcian Blue at pH 2.5 and pH 1. Of a population of 206 patients with EB from the Naval Hospital "Admiral Neff" Viña del Mar, between the years 2000-2006 to obtain a sample of 25 patients with dysplasia of which 18 (72%) showed low-grade epithelial dysplasia ( DBG) and 7 (28%) of highgrade epithelial dysplasia (DAG). We applied both pH (2.5 and 1) to each of the samples are then analyzed under a microscope, searching for mucosustancias acid secretion. In conducting both technical showed the presence of sulfomucinas and sialomucinas in 96% of the plates, indicating that only one case there was no staining and was at pH 1. It was determined that the presence of sialomucinas in epithelial dysplasia and sulfomucinas decreases markedly in the area displásica, mainly in the DAG.
Barrett's esophagus (BE) has been and will be the subject of investigation, it has a close relationship with gastroesophageal reflux. While intestinal metaplasia is not considered directly as a precancerous lesion, where a histological diagnosis for EB epithelial dysplasia and a risk of developing esophageal adenocarcinoma. Hence the importance of an accurate diagnosis for taking an appropriate clinical behavior. In the various types of intestinal metaplasia can be used as a marker of goblet cells, columnar cells and their secretion of acid mucusustancias by Alcian blue stain at pH 2.5 and pH 1, which stained the sialomucinas and sulfomucinas respectively. This allows us to classify the complete and incomplete metaplasia depending on the type of mucin secreted, the most acidic (sulfomucina) with the largest presence in epithelia with MI (intestinal metaplasia) type incomplete. This paper conducted a study in patients with histological diagnosis of EB, and these techniques were applied histochemistry Alcian Blue at pH 2.5 and pH 1. Of a population of 206 patients with EB from the Naval Hospital "Admiral Neff" Viña del Mar, between the years 2000-2006 to obtain a sample of 25 patients with dysplasia of which 18 (72%) showed low-grade epithelial dysplasia ( DBG) and 7 (28%) of highgrade epithelial dysplasia (DAG). We applied both pH (2.5 and 1) to each of the samples are then analyzed under a microscope, searching for mucosustancias acid secretion. In conducting both technical showed the presence of sulfomucinas and sialomucinas in 96% of the plates, indicating that only one case there was no staining and was at pH 1. It was determined that the presence of sialomucinas in epithelial dysplasia and sulfomucinas decreases markedly in the area displásica, mainly in the DAG.
Notas
Tesis (Tecnólogo Médico, especialidad en Morfofisiopatología y Citodiagnóstico)
Palabras clave
Esófago de Barrett, Mucinas ácidas, Displasia epitelial, Alcian Blue pH 2,5 y pH 1, Chile