A Clinicopathological Study on 11 Cases of Superficial Adenocarcinoma in the Barrett Esophagus

Akihiro Matsunaga, Masao Hosokawa, Yasuhiro Suzuki, Yasunori Nishida, Takaya Kusumi, Kanyu Nakano, Dai Taguchi and Masahiro Fujita*

Department of Surgery, Keiyukai Sapporo Hospital
Keiyukai Institute of Clinical & Surgical Pathology*

Background and Purpose: Esophageal carcinoma arising from Barrett's esophagus, Barrett's adenocarcinoma, accounts for roughly half of esophageal cancer occurring in European and American patients. The majority of esophageal cancer histology in Japanese patients is currently squamous cell carcinoma (SCC), but the prevalence of Barrett's adenocarcinoma is expected to increase as the traditional Japanese diet and physical constitution become "Westernized". We clarified clinicopathological features of Barrett's esophageal adenocarcinoma in Japanese patients. Methods: Clinicopathological features of 11 patients and 16 lesion with Barrett's superficial adenocarcinoma who had undergone esophagectomy were compared to those of 517 esophageal cancer patients with superficial squamous cell carcinoma (SCC). Results: Women predominanted in Barrett's superficial adenocarcinoma (27.3%) over those with superficial SCC (9.1%) (p=0.042). The percentage of heavy drinkers was relatively lower in Barrett's superficial adenocarcinoma than in superficial SCC. The incidence of multiple cancer development was higher in Barrett's superficial adenocarcinoma (45.5%) than in superficial SCC (14.3%) (p=0.016). Well-differentiated adenocarcinoma was seen in 14 of 16 lesion (87.5%) of Barrett's superficial adenocarcinoma, and 11 (68.7%) close to the squamocolomunar junction. Histological analysis of Barrett's mucosa around adenocarcinoma showed a specialized columnar type in 12 lesion (75%). Discussion and Conclusions: Our results are roughly consistent with previous reports, but the high incidence of women and multiple cancer development in Barrett's adenocarcinoma has not been well determined. Further study in thus are required to verify these features of Barrett's adenocarcinoma.

Key words
Barrett's esophagus, esophageal carcinoma

Reprint requests
Akihiro Matsunaga Department of Surgery, Keiyukai Sapporo Hospital
1-1 Kita, Hondori 14 Shiroishi-ku, Sapporo, 003-0027 JAPAN

Accepted
December 17, 2008

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