Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2770-2776
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2770
CDX2 protein expression compared to alcian blue staining in the evaluation of esophageal intestinal metaplasia
Dennis R Johnson, Maisoun Abdelbaqui, Maryam Tahmasbi, Zoltan Mayer, Hung-Wei Lee, Mokenge P Malafa, Domenico Coppola
Dennis R Johnson, Maisoun Abdelbaqui, Maryam Tahmasbi, Domenico Coppola, Department of Anatomic Pathology, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Zoltan Mayer, Hung-Wei Lee, Florida Digestive Health Specialists, Lakewood Ranch, FL 34202, United States
Mokenge P Malafa, Domenico Coppola, Department of Oncological Sciences, University of South Florida, Tampa, FL 33612, United States
Mokenge P Malafa, GI Tumor Program, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Domenico Coppola, Tumor Biology Program, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
Author contributions: Abdelbaqui M and Tahmasbi M performed the experiments; Johnson DR reviewed the results and drafted the manuscript; Mayer Z and Lee HW co-ordinated and provided the collection of part of the human material; Malafa MP and Coppola D reviewed the data and finalized the manuscript; and Coppola D designed the research.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Domenico Coppola, MD, Department of Anatomic Pathology, Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MCC-PATH, Tampa, FL 33612, United States. domenico.coppola@moffitt.org
Telephone: +813-745-3275 Fax: +813-449-8323
Received: July 18, 2014
Peer-review started: July 18, 2014
First decision: September 15, 2014
Revised: October 16, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: March 7, 2015
Core Tip

Core tip: Our data show that the use of CDX2 immunostain in biopsies performed to rule out esophageal intestinal metaplasia (Barrett esophagus) has the advantage of discriminating between Barrett’s esophagus and esophageal glands. The latter is typically strongly positive for alcian blue (AB) pH 2.5 but negative for CDX2. CDX2 also discriminates between BE and columnar blue cells which are also positive for AB. Our data shows that CDX2 has a better positive predictive value in detecting intestinal metaplasia as compared to AB (95.6% vs 71.5% respectively). These results support the utility of CDX2 stain in the correct diagnosis of Barrett esophagus.