Abstract

Eosinophilic esophagitis (EoE) has been recognized as a chronic disease of the esophagus in children and adults. Chronic inflammation of the esophagus may lead to malignant transformation of cells. Malignant or pre-malignant (dysplasia) conditions of the esophagus in EoE has not been reported. p53, a mutated intracellular oncogene marker, and Ki-67, a nuclear antigen associated with cell proliferation, were found to be increased in patients with Barrett's esophagus and esophageal cancer. Aim: To evaluate the presence of p53 and Ki-67 in children with EoE. Materials: Esophageal biopsies of children with EoE (Test Group), children with GERD (Control 1), adults with EoE (Control 2), adults with esophageal cancer (Control 3), and children with normal esophagus (Control 4), comprised our patient population. The immunreactivity of monoclonal oncogene p53 (DAKO, DO-7) and monoclonal Ki-67 cell marker (DAKO, Clone MIB-1) were utilized. Immunoreactivity of p53 was considered positive when at least 10% of the cells stained positive (Wang 1993). Ki-67 immunoreactivity was calculated as a percentage of positive cells per at least 500 cells (Feith 2004). Results: A total of 50 esophageal biopsies were available, 25 children with EoE, 15 children with GERD, 15 children with normal esophagus, 3 adults with EoE, and 2 adults with esophageal cancer. p53 was negative in normal mucosa but was Ki-67 positive in the basal layer (proliferative zone). Adult biopsies with esophageal cancer were positive for both markers. Immunoreactivity of p53 and Ki-67 was significantly higher in EoE vs. normal esophagus (Table). Conclusion: Oncogene p53 and Ki-67 immunoreactivity were higher in the EoE compared to the GERD and the normal group. Our data suggested an active cell proliferation in the esophagus of children with EoE and GERD. Whether the positive immunoreactivity of p53 in EoE children represents a real genetic mutation or false positive results is yet to be resolved (Rice 1994). Oncogene immunoreactivity in EoE

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