Background/aims: Hematoxylin-eosin stain may fail to show intestinal metaplasia in Barrett's esophagus, and PAS-alcian blue may present difficulties of interpretation due to its more heterogeneous staining. We investigated whether Mucin-2 is a good substitute for PAS-alcian blue in the detection of goblet cells.

Methodology: Biopsy specimens from 47 Barrett's esophagus patients were stained with hematoxylineosin and PAS-alcian blue. Mucin-2 expression was evaluated with monoclonal antibody. The intra- and interobserver agreements about the expression of Mucin-2 and PAS-alcian blue stain were determined by kappa statistics.

Results: PAS-alcian blue and Mucin-2 were positive in all cases. Mucin expression was positive in goblet cells and few columnar cells. PAS-alcian blue showed heterogeneous staining. The columnar epithelium and the submucosal glands were also stained. Intra- and interobserver agreement in the identification of intestinal metaplasia was 100%.

Conclusions: Mucin-2 agreed fully with PAS-alcian blue. The intra- and interobserver agreement was perfect, justifying its use in the diagnosis of Barrett's esophagus.

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