[ABSTRAK
Latar Belakang : Esofagus Barrett (EB) merupakan lesi premalignaadenokarsinoma esofagus yang meningkatkan risiko menjadi adenokarsinomasebesar 30-125 kali. EB didefinisikan sebagai perubahan epitel esofagus normaldigantikan oleh epitel kolumnar metaplastik, meskipun secara universal belum adakesepakatan definisi. Kehadiran sel goblet (metaplasia intestinal) sebagai penandaEB hingga saat ini masih kontroversi. CDX2 adalah gen regulator transkripsi dalamdiferensiasi intestinal dan diketahui terekspresi pada EB. Studi mengenai ekspresiprotein Cdx2 menggunakan pulasan imunohistokimia pada EB dengan metaplasiakolumnar (MK) maupun metaplasia intestinal (MI) masih terbatas. Penelitian inibertujuan untuk mengetahui ekspresi Cdx2 pada EB dengan MK dan MI sertahubungannya dengan derajat keparahan endoskopi.Bahan dan cara : Dilakukan pulasan imunohistokimia Cdx2 pada 38 kasus dari 19pasien EB dengan MK dan 19 dengan MI. Penilaian dilakukan dengan menghitungskor pulasan yang menilai intensitas pulasan dan persentase area positif.Imunoekspresi Cdx2 dinilai positif apabila skor pulasan ≥ 0,1.Hasil : Ekspresi Cdx2 ditemukan pada 12 (63,16%) kasus MK dan pada 16(84,21%) kasus MI. Didapatkan nilai median kelompok MK sebesar 0,15 dan MIsebesar 0,58. Terdapat perbedaan bermakna antara skor Cdx2 pada kelompok MKdan MI (p=0,05). Diperoleh korelasi bermakna antara kehadiran MI dan skor Cdx2dengan nilai korelasi positif lemah (0,322). Tidak terdapat hubungan bermaknaantara derajat keparahan endoskopi dengan jenis metaplasia (p=0,794), derajatinflamasi berdasarkan histopatologik (p=0,300) maupun dengan positivitas Cdx2(p=0,278).Kesimpulan : Hasil penelitian menunjukkan ekspresi Cdx2 dapat digunakan sebagai penanda kehadiran MI pada kasus EB dengan MK tanpa gambaran sel goblet.ABSTRACT Background : Barrett?s Esophagus (BE) is premalignan lesion of the esophageal

adenocarcinoma that increases risk of adenocarcinoma as much as 30-125 times.

BE is defined as normal esophageal epithelium that is changed by columnar

epithelial metaplasia. Nevertheless, there is no general agreement about its

definition yet. Currently, the presence of goblet cell (intestinal metaplasia) as an

indicator of BE is still controversial. Cdx2 is a regulator transcript gene in intestinal

differentiation and is known expressed in BE. Study about Cdx2 protein expression

using immunohistochemistry staining in BE with columnar metaplasia (CM) or

intestinal metaplasia (IM) is still limited. This research is intended to find Cdx2

expression in BE with CM and IM as well as its relationship with the severity degree

of endoscopy.

Material and Method : Immunohistochemistry staining of Cdx2 was performed

on 38 cases (i.e. each 19 BE patients with CM and IM). The assessment was

evaluated by calculating staining score that assessed staining intensity and

percentage of positive area. Immunoexpression was considered as positive if

staining score ≥ 0.1.

Result : Cdx2 expression was found on 12 CM patients (63,16%) and 16 IM

patients (84,21%). Median scores of 0,15 and 0,58 were obtained from CM and IM

groups, respectively. There was a significant difference between Cdx2 score of CM

group and IM group (p = 0,05). Significant correlation between the presence of IM

and Cdx2 score was weak positive (0,322). There was no relationship between

severity degree of endoscopy with types of metaplasia (p=0,794), histopathologic

inflammation degree (p=0,300) or Cdx2 positivity (p=0,278).

Conclusion : This study shows that Cdx2 expression can be used an indicator of IM presence on EB cases with CM without goblet cell appearance.;Background : Barrett?s Esophagus (BE) is premalignan lesion of the esophageal

adenocarcinoma that increases risk of adenocarcinoma as much as 30-125 times.

BE is defined as normal esophageal epithelium that is changed by columnar

epithelial metaplasia. Nevertheless, there is no general agreement about its

definition yet. Currently, the presence of goblet cell (intestinal metaplasia) as an

indicator of BE is still controversial. Cdx2 is a regulator transcript gene in intestinal

differentiation and is known expressed in BE. Study about Cdx2 protein expression

using immunohistochemistry staining in BE with columnar metaplasia (CM) or

intestinal metaplasia (IM) is still limited. This research is intended to find Cdx2

expression in BE with CM and IM as well as its relationship with the severity degree

of endoscopy.

Material and Method : Immunohistochemistry staining of Cdx2 was performed

on 38 cases (i.e. each 19 BE patients with CM and IM). The assessment was

evaluated by calculating staining score that assessed staining intensity and

percentage of positive area. Immunoexpression was considered as positive if

staining score ≥ 0.1.

Result : Cdx2 expression was found on 12 CM patients (63,16%) and 16 IM

patients (84,21%). Median scores of 0,15 and 0,58 were obtained from CM and IM

groups, respectively. There was a significant difference between Cdx2 score of CM

group and IM group (p = 0,05). Significant correlation between the presence of IM

and Cdx2 score was weak positive (0,322). There was no relationship between

severity degree of endoscopy with types of metaplasia (p=0,794), histopathologic

inflammation degree (p=0,300) or Cdx2 positivity (p=0,278).

Conclusion : This study shows that Cdx2 expression can be used an indicator of IM presence on EB cases with CM without goblet cell appearance., Background : Barrett’s Esophagus (BE) is premalignan lesion of the esophageal

adenocarcinoma that increases risk of adenocarcinoma as much as 30-125 times.

BE is defined as normal esophageal epithelium that is changed by columnar

epithelial metaplasia. Nevertheless, there is no general agreement about its

definition yet. Currently, the presence of goblet cell (intestinal metaplasia) as an

indicator of BE is still controversial. Cdx2 is a regulator transcript gene in intestinal

differentiation and is known expressed in BE. Study about Cdx2 protein expression

using immunohistochemistry staining in BE with columnar metaplasia (CM) or

intestinal metaplasia (IM) is still limited. This research is intended to find Cdx2

expression in BE with CM and IM as well as its relationship with the severity degree

of endoscopy.

Material and Method : Immunohistochemistry staining of Cdx2 was performed

on 38 cases (i.e. each 19 BE patients with CM and IM). The assessment was

evaluated by calculating staining score that assessed staining intensity and

percentage of positive area. Immunoexpression was considered as positive if

staining score ≥ 0.1.

Result : Cdx2 expression was found on 12 CM patients (63,16%) and 16 IM

patients (84,21%). Median scores of 0,15 and 0,58 were obtained from CM and IM

groups, respectively. There was a significant difference between Cdx2 score of CM

group and IM group (p = 0,05). Significant correlation between the presence of IM

and Cdx2 score was weak positive (0,322). There was no relationship between

severity degree of endoscopy with types of metaplasia (p=0,794), histopathologic

inflammation degree (p=0,300) or Cdx2 positivity (p=0,278).

Conclusion : This study shows that Cdx2 expression can be used an indicator of IM presence on EB cases with CM without goblet cell appearance.]