Assessment of oesophagitis by histology and morphometry

Abstract

Morphometric measurements of nuclear area, nuclear concentration and nucleolar dimensions in defined tissue zones of orientated oesophageal biopsy sections were compared between three patient groups--asymptomatic/normal endoscopy (n = 8); symptomatic reflux/normal endoscopy (n = 17); and symptomatic/endoscopic oesophagitis (n = 15). No significant differences could be shown for any mean parameter between clinical groups. In a further group of 16 patients, identical morphometric measurements were made in non-orientated grasp biopsies and correlated with prolonged ambulatory pH data. No significant correlations could be shown between nuclear parameters and acid reflux measurements. These results suggest that morphometric measurement cannot be recommended as a diagnostic tool in the diagnosis of oesophagitis, although it may be useful in the assessment of individual therapeutic response in clinical trials.

Altered intercellular glycoconjugates and dilated intercellular spaces of esophageal epithelium in reflux disease

“…This allows potential application in routine histological diagnosis. An advantage of ISD as a diagnostic tool for GERD stems from the fact that it does not require proper orientation of the mucosa in histological sections, a strict requirement for the assessment of papillae elongation and basal cell hyperplasia [14] which proved difficult to fulfil in routine grasp biopsies [4,16]. In addition, we found no substantial difference between the results of biopsies taken at different distances from the squamo-columnar junction, a factor which has been suggested to affect the specificity of other histological tools [31].…”

“…The diagnostic value of these findings has been the subject of many investigations leading to conflicting results [4,25,30]. In general, histological lesions were well represented in the esophageal mucosa, showing erosive esophagitis at endoscopy.…”

Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms

“…All oesophageal biopsies were assessed for the presence or absence of intra-epithelial eosinophilic and neutrophilic granulocytes, lymphoid cells, mast cells, basal cell hyperplasia, elongation of the papillae, microscopic erosion or necrosis, and columnar metaplasia [31,32]. For the assessment of 'basal cell' hyperplasia, the cytologic criteria of choice were those devised by Jarvis et al [33] (nuclear size and crowding, prominence of nucleoli and cytoplasmic basophilia of the basal as well as of the intermediate layers of the epithelium) because, unlike other, more commonly used criteria [34] [35].…”

What Parameters Are Relevant for the Histological Diagnosis of Gastroesophageal Reflux Disease without Barrett’s Mucosa?

“…Therefore, this combination has been regarded as an unspecific normal variant [14][15][16][17]. It has been demonstrated that antacids [18] and H 2 blockers [19] do not lead to changes in basal cell hyperplasia and length of papillae.…”