Z Gastroenterol 2004; 42 - 91
DOI: 10.1055/s-2004-826992

Evaluation of cell cycle and intestinal metaplasia related immunohistochemistry data in esophageal biopsy specimen by optical, virtual microscopy and digital slide based automated counting methods

M Máté 1, A Bálint 1, F Sipos 2, B Molnár 2, L Ficsór 2, J Regöly-Mérei 1, Z Tulassay 2
  • 13rd Department of Surgery, Szent István Hospital, Budapest
  • 22nd Department of Medicine, Semmelweis University, Budapest

Background: Cell cycle related protein determinations in Barrett esophagitis, reflux esophagitis, healthy esophageal and cardiac biopsy specimens can yield important data. Immunohistochemical (IHC) evaluation on optical microscope is a time-consuming and semi-quantitative method. Application of digital slides and virtual microscopy for manual and automated counting can enhance this procedure.

Aims: Determination of PCNA, p53, SIMA, LIMA expression data on routine esophageal biopsy sections and comparison of traditional to digital counting methods developed in our laboratory.

Methods: 30 healthy esophagus, 30 reflux esophagitis, 30 Barrett and 10 healthy gastric cardia biopsy sections were examined by PCNA, p53, SIMA and LIMA IHC. With both microscopic processes at least 1000 cells were counted. In the automatic digital slide based procedure the epithelial surface and gland structures were first segmented and positive cells were determined and counted.

Results: PCNA expression was in correlation with the cardiac type gastric tissue and was significantly lower, as was in reflux esophagitis. p53 and SIMA expression showed significant correlation with each other. Manual counting using virtual microscopy is a faster procedure and more convenient than the optical one. Automated counting of positive cells is in correlation to the manual methods.

Conclusion: Barrett esophagus shows similar cell cycle related protein expression pattern to the cardia. The presence of intestinal metaplasia is in correlation with increased p53 expression. Virtual microscopy and automated analysis is applicable for IHC evaluation of esophageal biopsy sections.