Barrett食管上皮的微细结构及意义

目的 通过透射电镜技术观察Barrett食管上皮的超微结构变化,并探讨其意义.方法 内镜下诊断Barrett食管,在食管下段行内镜下黏膜活检,标本分别经福尔马林、戊二醛固定,对经内镜及病理证实为Barrett食管伴肠上皮化生的黏膜行透射电镜观察.结果 Barrett食管上皮超微结构显示兼有鳞状上皮和腺上皮的结构特征,并多见一种形态特征介于黏液细胞和杯状细胞之间的"中间体"细胞.结论 Barrett食管上皮超微结构提示Barrett上皮可能起源于食管的多能干细胞,并具有多向分化潜能.

Ultrastructure of Barrett's esophageal epithelium and its significance

Objective To observe the ultrastructure of Barrett's esophageal epithelium by transmission electron microscopy and to investigate the related clinical significance. Methods Barrett's esophagus was screened by endoscopy. Biopsy specimens in the distal oesophagus were fixed in 10% buffered formalin for the histopathological diagnosis. Some biopsy specimens from the patients with Barrett's esophagus showing special-ized intestinal epithelium were fixed in 2.5% glutaraldehyde for subsequent study by transmission electron mi-croscopy. Results Transmission electron microscopy found an intermediate cell type between the mucous cell and the goblet cell in the surface of Barrett's specialized intestinal metaplasia and a special cell type with both squamous and columnar cell features under the surface of Barrett's specialized intestinal metaplasia. Conclu-sion The special cell type of both squamous and columnar cell features found by transmission electron micros-copy may be the result of transformation of muhipotential stem cells of squamous epithelial origin. The interme-diate cells may represent an intermediate stage in the development of Barrett's specialized intestinal metaplasia.