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J Clin Pathol 56:703-708 doi:10.1136/jcp.56.9.703
  • Original article

Detection of sulfated glycoproteins in intestinal metaplasia: a comparison of traditional mucin staining with immunohistochemistry for the sulfo-Lewisa carbohydrate epitope

Table 1

Prevalence of different subtypes of intestinal metaplasia (IM) based on high iron diamine (HID)/alcian blue (pH 2.5) mucin histochemistry

Diagnostic group Number of patients evaluated (number of sections) Type I IM (no. patients) Type II IM (no. patients) Type III IM (no. patients)
Type I IM: alcian blue positive goblet cells and non-secretory “absorptive-type” cells with no HID or sulfo-Lewisa staining (fig 1A,B). A few isolated mature goblet cells may show HID positivity with corresponding immunoreactivity for sulfo-Lewisa in serial section (100% agreement). Type II IM: alcian blue positive goblets cells and incompletely differentiated “intermediate-type” cells having alcian blue positive apical secretory granules, without HID or sulfo-Lewisa staining (fig 1C,D). The deeper glands, and occasional surface goblet cells, may show HID positivity and corresponding sulfo-Lewisa expression (100% agreement). Type III IM: HID positive goblets cells and incompletely differentiated intermediate-type cells having HID positive apical secretory granules with corresponding sulfo-Lewisa expression (100% agreement). Dysplasia: the dysplastic cells themselves exhibited variable HID staining (mainly localised to the apical membrane) and there was occasional discordance between mucin histochemistry and the sulfo-Lewisa staining (that is, HID negative but sulfo-Lewisa positive; see Results). Adenocarcinoma: the cancer cells themselves exhibited variable HID staining and there was some discordance between mucin histochemistry and the sulfo-Lewisa staining as in dysplastic epithelium (see Results).
Barrett’s oesophagus 13 (38) 11/13 13/13 8/13
Barrett’s oesophagus with dysplasia 8 (35) 8/8 7/8 3/8
Barrett’s adenocarcinoma 3 (7) 2/3 3/3 3/3
Gastric IM 7 (21) 6/7 3/7 2/7
Gastric IM with dysplasia 4 (12) 1/4 3/4 2/4
Gastric adenocarcinoma (distal) 3 (12) 1/3 3/3 1/3

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